There's no such thing as a free coffee in Pharma

Is a free cup of coffee in a conference exhibitor’s booth an inducement to prescribe?

Image by Omar_MK via Flickr

It was interesting to see exhibitors at the recent American Society of Hematology meeting place conspicuous signs in booths that had a café, alerting health care professionals that they should not ask for a free cup of coffee, tea or water if their licensing State, Government or Institution prohibited them from doing so. 

Massachusetts and Vermont are two states that have recently banned health care professionals with prescribing authority from accepting anything of value directly from a pharmaceutical or medical device manufacturer including food & drink where the gift is linked to promotional activities.  Other states such as New Jersey may soon follow suit.

Manufacturers are businesses with products to promote.  They try and attract health care professionals to stop by their exhibits by offering information, and in some cases comfortable seating or refreshments such as biscotti or small ice cream.  Nobody raises any questions about the subsidy to the meeting costs that exhibitors effectively provide, yet the offer of a coffee, tea or water at a booth that a doctor, nurse or physician’s assistant voluntarily chooses to visit is now regarded as a “gift” that several states have banned.

To me, the pendulum has swung too far in the regulation of pharmaceutical promotional activity if people really think a health care professional is induced to prescribe based on a free coffee at a conference exhibit booth. It is rather insulting if regulators think a doctor can be so easily bought. 

If fewer health care professionals visit the booths due to lack of chotckhes or refreshments, the day may well soon come when exhibitors begin downsizing their booths and paying less for the privilege.  The end result in the long run may well be higher registration fees for all, including physicians.

Perhaps there should be a minimum value of “gift” that is regarded as ‘de minimis’ and exempt from oppressive regulation.  Long live free coffee at conference exhibit booths!

Comments

[Karen]

Interesting that the people passing theses laws receive huge amounts in campaign contributions, PAC money, free trips, and other monetary perks. Are doctors so low in ethics that a cup of coffee will sway them to prescribe a drug unnecessarily while a congressman is so ethical that taking a trip sponsored by big oil would have no impact on how he votes on a bill to drill in a protected area? Where would our public officials be without their chotckhes?

[MaverickNY]

Good points, Karen.

Of course, no one has probably asked Sen. Grassley and his colleagues whether he takes these benefits or declines them for fear of tainting his independent judgement.

We must also remember that the House and Senate have perhaps one of the most generous health plans in the country, so asking them to consider offering their humble constituents similar benefits in the health care reform bill is possibly a bridge too far.

[Dana]

My point was going to be the same as Karen's. Many industries spend millions of dollars in lobbying Congressional representatives in hopes of influencing their opinion on legislation.

The way our government operates is very much quid pro quo - you vote this way for my cause, I'll return the favor when you need it. No one is bringing this practice up in the current Health Care Reform debate. But, states now prohibiting a $0.25 cup of coffee is going off the deep end.

I came into the pharmaceutical industry at the end of the old days of branded golf balls and afternoon ice cream socials. I've brought my fair share of meals into offices, but it was always in accordance with office, company, and PhRMA policies.

We are on a slippery slope of regulation that could very easily stifle innovation. I'd be interested to see how many of our legislators have personally invested in pharmaceutical/medical device companies in the past or presently contributing to their personal wealth/gain.

[MaverickNY]

Thanks for your comments, Dana.

Can't say I disagree with any of your well made points.

It's interesting that the State Medical Associations in MA, VT and NJ seems to be standing by and give the impression that their members are persuaded by even such small refreshments for their weary doctors at long conferences.

Legislators and lobbyists is not something a European understands very well, but it would seem from the outside that there is more opportunity to be influenced than a small cup of ice cream or water.

[Kim D. Slocum]

What industry needs to realize is the deep distrust in which it is held by the public and that much of this regulation is simply a response to the popular will. Within the past four months, two polls (one from Harris Interactive and the second from the Kaiser Family Foundation) have shown that roughly 4 in 5 people say the industry bears much of the blame for the current problems in health care. This is second only to the most reviled group in the country today, health insurers. The Kaiser poll further found that the pharma industry ranked dead last in terms of groups the public trusted to "do the right thing" regarding health care. This is truly a sad state of affairs for an industry that has done so much to improve the quality and quantity of human life. So where's the disconnect?

Nearly all of this distrust is driven by things that happen in the sales and marketing functions. Pfizer's $2.3 billion fine for Neurontin marketing activities, the Congressional review of Forest's marketing plan for Lexapro, the recent legal action against J&J, Lilly's problems with Zyprexa, Merck's Vioxx marketing issues and a host of others with PR implications are all still recent memories. As a result, it's hardly surprising that the general public feels the way it does. The regulatory pressure is simply a tangible manifestation of what average folks see in the media.

I'm a former pharmaceutical executive who now does strategy/policy consulting with not only biopharmas but other stakeholders as well, so I'm not speaking out of either ignorance or malice. I'd love to see the industry rehabilitate it's image, but to do so, it will need to take a hard look in the mirror. Contrary to prevailing opinion, the marketing of biopharmaceuticals isn't like selling soap. The public simply holds health care companies to a higher standard and expects better conduct as a result.
The sooner industry realizes this and starts to market products in partnership with its other stakeholders (as opposed to the current "zero-sum game" efforts so commonly seen) the sooner it will be able to improve its tarnished reputation.

[MaverickNY]

Thanks for your comments, Kim.

How would you suggest the partnerships with other stakeholders evolve?