Task Force: Ban Drug Reps From 'Ivory Towers'

Excerpted from Task Force: Ban Drug Reps From 'Ivory Towers' MedPage Today. December 11, 2013 -- Drug sales reps should be banned from academic medical centers, but mingling between faculty and pharma researchers is not a problem, according to a conflict-of-interest task force.

"Pharmaceutical sales representatives should not be allowed access to any faculty, students or trainees in academic medical centers or affiliated entities," the task force, convened by the Pew Charitable Trusts, wrote in a 30-page report released in December. "However, faculty may invite pharmaceutical scientists for specific educational or scientific discussions that do not involve marketing of a specific product."

The task force—with representatives from seven academic medical centers, various consumer organizations, the Association of American Medical Colleges (AAMC) and the American Medical Student Association—referenced a review of 29 studies that found physicians who interacted with sales reps prescribed lower-quality, higher-cost drugs compared with non-exposed doctors. Current AAMC policy recommends that sales reps only be allowed on academic medical centers by appointment and that they be prohibited from entering patient-care areas.

Banning sales reps is one of seven recommendations the task force made, all of which would tighten current AAMC recommendations. The conflict-of-interest policies should also apply to training sites such as affiliated hospitals and clinics, the task force recommended. Of the 15 recommendations made, several vary at least somewhat slightly from what the AAMC already recommends to its member schools.

The Pharmaceutical Research and Manufacturers of America (PhRMA), an industry trade group, said it was important for the development of new drugs and for patient safety that physicians and drug companies maintain collaborations. “While PhRMA is still reviewing the findings of the Pew Charitable Trusts’ report, it is important to stress the importance of collaborations between biopharmaceutical research companies and physicians, including at academic medical centers,” PhRMA Executive Vice President Bill Chin, MD, told MedPage Today in a statement. “These interactions improve patient care and contribute significantly to scientific innovation.”

Commentary

CMDA Member and Associate Professor of Anesthesiology J. Grady Crosland, MD, MAR: “‘Whatever it is, I fear Greeks even when they bring gifts’ (Virgil’s Aeneid).

“Thus was ‘there is no free lunch’ announced two millennia ago. Men have always expected a quid pro quo. Our fallen human nature leads us into temptation. The question is how do we respond to it? Social scientists say it doesn’t take much to create a sense of indebtedness in those who receive unsolicited gifts.¹ I much prefer to teach virtue ethics as a part of the core competency of professionalism. Make the ‘weaker brother’ stronger and leave personal choice to the individual physician.”

¹Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review. Geoffrey K. Spurling et al. PLOS: Medicine, October, 2010.

Resources
Ethics Statement – Doctor and Pharmaceutical/Medical Device Industry Relationship
Professionalism in Peril