Friday, July 11, 2008

PhRMA Marketing Code: Throw Away Those Pens, The Time Is Perfect

Talk about a perfect sense of timing.

The Pharmaceutical Research & Manufacturers of America unveiled its new marketing code (“Code on Interactions with Healthcare Professionals”) on July 10: one day after the Senate passed the Medicare physician payment extension (HR 6331).

PhRMA announced the unanimous commitment of its board to throw away pens and trinkets as marketing gimmicks among a wide range of changes to old drug marketing practices.

The jettisoning of the pens is an apt symbol of the larger changes underway in the drug business, and PhRMA couldn’t have found a more fitting time for the symbol.

For the Medicare bill contains its own version of a de-penestration of the drug industry: a carrot-and-stick payment adjustment to doctors to speed the adoption of e-prescribing.

The pharma companies might as well have said to the docs we don’t need to give you pens anymore, you won’t be using them for long anyway.

Beyond the engaging symbolism of throwing away the pens. the July 10 unveiling of the PhRMA code was also well-timed to show that industry’s self-regulation of marketing practices appears to have survived another major challenge.

Coming a day after the bill passed without new restrictions on drug marketing practices, the industry’s voluntary code demonstrates that the industry has responded to the recent round of criticisms and has effectively taken charge of the issue: specifying its own changes instead of being forced to adopt changes by outside parties.

Sen. Grassley (R-Iowa) had been pushing to attach a Physician Payment Sunshine provision to the recent Medicare bill.

Now that the threat has passed for this session, PhRMA has a chance to try to make its voluntary code satisfy the demands for changes to marketing practices.

As PhRMA President Billy Tauzin describes it: Members of Congress appreciate it when an industry under criticism shows that it can listen and respond on its own. The former House Energy & Commerce Committee chairman points out that there is “less enthusiasm” for legislating when companies manage their own ethics.

And the changes being adopted by PhRMA in this round of changes (the last major changes occurred in 2002) are substantial.

In addition to getting rid of the small gifts, PhRMA is urging companies to set publicly stated “caps” on payments to physicians for speaking engagements. “Each company should, individually and independently, cap the total amount of annual compensation it will pay to an individual healthcare professional in connection with all speaking arrangements.”

PhRMA’s critics have adopted transparency as a way to discourage payments between industry and the medical professions. Learning from its critics, PhRMA says that policies on speaker choice, training and compensation should be publicly divulged by individual companies, preferably on their websites.

As a trade association, PhRMA cannot set limits on speaker compensation for its members. It is relying on the encouragement for firms to make that information public to serve as a indirect form of enforcement.

As Tauzin explained at the industry wants to show that it has heard the criticisms from a variety of sources (political, the medical professions and the media) and the pharma companies want to show that they have been listening.

One of the toughest issues for PhRMA was the policy towards meals. As we predicted previously (see here), PhRMA came up short of banning all meals for doctors and supporting medical staff.

The new code does come out strongly against meals beyond a doctor’s office or medical institution. “Meals offered in connection with informational presentations made by field sales representatives or their immediate managers should also be limited to in-office or in-hospital settings.”

Defending the decision to permit some “modest” meals, Tauzin mentioned several that even “the counterdetailers” will attest to the need to offer some food to get the attention and time of busy medical staffs.

But even take-out meals will require a new level of decorum. “Offering ‘take-out’ meals or meals to be eaten without a company representative being present (such as ‘dine & dash’ programs) is not appropriate.”

PhRMA had a very modest spread of sandwich fixings on a side table in the room for journalists to hear about the new code on July 10. In the new spirit of serious communications, however, the press conference ran long and the sandwiches went uneaten.

If PhRMA can engage journalists without food and entertainment maybe its members will have similar success with the medical professions.

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