Our Views

Lawmakers in Massachusetts have decided they’ve had enough of Big Pharma “bribing” physicians, and if a new bill becomes law, allows fines of up to $5,000 for even offering a gift.

The Massachusetts state Senate has approved a bill containing a sweeping package of reforms it hopes will control skyrocketing health-care costs. Among other measures, the bill bans Big Pharma from giving gifts of any value to physicians and health care facilities.

The state’s doctor-gift provision may get Big Pharma’s attention, since it has the teeth that were missing in a federal bill proposed recently by Herb Kohl (D., WI), and Chuck Grassley (R., IA), which we discussed recently in Our Views, requiring Big Pharma only to report all payments and gifts made to physicians. Massachusetts first-of-its-kind bill actually sets fines of up to $5,000 for Pharma or device marketers who “offer or give to a physician, a member of a physician’s immediate family, a physician’s employee or agent, a healthcare facility or employee or agent of a healthcare facility, a gift of any value.”

An earlier version of the bill made such gifts a crime, but the criminal clause was removed from the final version. Before taking effect, the bill must pass the state House of Representatives and be signed by Governor Deval Patrick.

Reaction from the industry has been predictably noisy, including an op-ed piece in the Boston Herald by two notable physicians, Dr. Thomas Stossel of Harvard and his colleague, Dr. Dennis Ausiello, who decry the bill as a really bad idea. But as Dr. Howard Brody points out in his blog Hooked, Ausiello is a director at Pfizer and Stossel is a paid consultant to Merck, with each having several other major interests as well. What else are they going to say?

Banning pharma gifts is a trend, not some solitary new idea

The writing is on the wall. Gifts from Big Pharma and its device-making counterparts may soon be unwelcome at all 129 of the nation’s medical colleges, according to a new report from the Association of American Medical Colleges, which spent two years on the project. Also, according to The Prescription Project, in 2007 over half of all state legislatures considered bills addressing various aspects of bribery-based pharmaceutical marketing, and more of them will soon follow suit. In Minnesota, gifts worth more than $50 are banned already, and Vermont requires public disclosure of gifts over $25.

Not only that, many academic medical centers have banned drug company gifts, including Yale, Stanford, University of Michigan, University of Pennsylvania, Boston Medical Center, Vanderbilt University, University of Pittsburg, and University of Massachusetts. And the University of California will soon follow with its gift ban.

Of course, banning gifts is only the first step to putting integrity back into our medical system. As long as academic medical centers continue to rely on huge “grants” from Big Pharma to fund medical research, the “results” will never truly be independent. As long as most of the continuing medical education available to doctors is funded by drug companies who promote their products then doctors will not really receive unbiased information.

Although we’d liked to have seen the criminal felony clause retained in the bill, the $5000 fine for even offering a gift is a start. We hope the House and the Governor approves it. Hitting Big Pharma in the pocket book may be the only thing this industry understands. Big Pharma should just knock off the bribery. If their products really work they will be purchased—just like any other product.

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