UC-Davis banning free sampes from pharma
Move seen as way of reducing conflict of interest
The number of academic medical centers that are banning free drug samples, free lunches, and other gifts from pharmaceutical company representatives remains small, but continues to grow. Sacramento, CA-based University of California–Davis (UC Davis) Health System is the latest to approve policies aimed at reducing pharma's influence on physicians and other health care staff.
Starting in July 2007, UC Davis will ban health system employees from accepting free drug samples, food, beverages, pens, notepads, and any other marketing items. Further, pharma sales reps will no longer be permitted "preceptorships" that allow them to accompany physicians during patient encounters.
"These measures are a reflection of our desire to reduce any real or perceived conflict of interest involving our relationships with the pharmaceutical industry," UC Davis clinical care medical director Timothy Albertson, MD, said in announcing the new guidelines.
UC Davis joins Stanford University, Yale, and the University of Pennsylvania, all of which have adopted similar policies guarding against pharma influence.
Pharma gifts bring benefits, conflicts
UC Davis' prohibition on samples and gifts from drug companies mirrors a policy proposal issued a year ago in the Journal of the American Medical Association, which states that while pharmaceutical companies have provided benefits to patients through research into and development of new drugs, their fiduciary responsibility to stockholders frequently blurs the line between patient welfare and profit-seeking.1
The JAMA proposal identified physicians' behavior as part of the conflict-of-interest problem, and urged academic medical centers to prevent further compromises to professional integrity by prohibiting practices that could create conflicts of interest with drug and medical device companies.
The ban on preceptorships at UC Davis goes beyond what the JAMA proposal called for, however. The preceptorship program allows pharma sales representatives, in exchange for a fee, to accompany physicians during patient visits, giving the drug representatives the opportunity to cement their relationships with the doctors.
New committee oversight created
UC Davis' new system will include the Vendor Relationships Subcommittee, which will review and recommend policy changes for all potential conflicts of interest in relationships between health system staff and vendors, including equipment manufacturers, implant and device suppliers, medical supply providers, and pharmaceutical suppliers.
Acknowledging that some patients could suffer when free samples are eliminated, a new program will permit patients who meet specific income criteria to receive free or discounted drugs.
The JAMA proposal addresses academic medical centers specifically because of the ripple effect of their policy making and because of their role in training new physicians, but points out that physicians in any setting can be subject to an unconscious urge to reciprocate when gifts accompany drug samples.
Such proposals are opposed by the Pharmaceutical Research and Manufacturers of America (PhRMA), the largest pharmaceutical industry association in the country. PhRMA insists, in a policy statement issued in 2006, that restricting sales representatives' access to physicians effectively cuts off doctors from prime sources of information on new medications and devices.
Reference
- Brennan TA, Rothman DJ, Blank L, et al. Health industry practices that create conflicts of interest. A policy proposal for academic medical centers. JAMA 2006; 295:429-433.
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