Non-educational “reminder” items such as pens and mugs emblazoned with company logos are no longer to be distributed to US health care providers and their staff, says the Pharmaceutical Research and Manufacturers of America’s (PhRMA) revised Code on Interactions with Healthcare Professionals, which was published yesterday and takes effect next January.

Such items, even though of minimal value, “may foster misperceptions that company interactions with health care professionals are not based on informing them about medical and scientific issues,” says the Code, which is voluntary.

Nor will company representatives be allowed to take doctors and other health professionals out to restaurants, although they will be permitted to provide “occasional meals in healthcare professionals’ offices in conjunction with information presentations,” says PhRMA. The revised Code “also reaffirms and strengthens previous statements that companies should not provide any entertainment or recreational benefits to healthcare professionals,” it adds.

The revised document, which replaces the Code which has been in place since 2002, also includes new provisions which require drugmakers to ensure that their reps are “sufficiently trained” about laws, regulations and all industry codes of practice that govern interactions with healthcare professionals, to assess their reps periodically and “take appropriate action if they fail to comply with relevant standards of conduct.”
PhRMA member companies must state their intentions to abide by the Code, and their chief executives and compliance officers must certify annually that they have compliance processes in place, it adds. Firms are also “encouraged” to provide external verification periodically that they have processes in place to foster compliance with the Code, and the association will post on its web site a list of all companies that pledge to follow it, with contact information for the firms’ compliance officers.

“Although our member companies have long been committed to responsible marketing of the life-enhancing and life-saving medicines they develop, we have heard the voices of policymakers, healthcare professionals and others telling us we can do better,” said PhRMA’s chief executive, Billy Tauzin.

A number of companies announced immediately that they would adopt the new code, including Johnson & Johnson, Astra Zeneca, Eli Lilly, Amgen and EMD Serono.

“The revised code complements our philosophy that any interaction with healthcare providers should be about providing information that helps them decide on the right medicines, for the right patients, at the right time,” said Rich Fante, vice president of brand and portfolio operations at AstraZeneca. “We are in favor of changes that benefit patient care,” he added.

Maine, Minnesota, Vermont and West Virginia already have laws setting monetary limits and disclosure provisions on the gifts which drug reps can offer to doctors and other health care professionals, and other states are considering such moves. In Massachusetts, legislation to ban gifts outright is proposed by state Senate President Therese Murray, a prospect which caused Christopher Viehbacher, president of US pharmaceuticals at GlaxoSmithKline (GSK), to warn state political leaders in May that this would make Massachusetts ‘“the most hostile state in the nation when it comes to biopharmaceutical sales.”

The Physician Payment Sunshine Act, sponsored in the House by Democrats Pete Stark and Peter Defazio and in the Senate by Republican Charles Grassley and Democrat Herb Kohl, seeks to introduce such controls nationally. In May, PhRMA told the Senators that their bill was “acceptable,” provided it retained a provision that preempts state law.

The executive council of the Association of American Medical Colleges (AAMC) has also called on medical schools to reject gifts, travel and other services from pharmaceutical companies, in order to avoid conflicts of interest.