Healthy Skepticism Library item: 2186
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
AMA Discourages Drug Co. Gifts
New York Times 2001 Aug 29
Full text:
CHICAGO (AP) — The American Medical Association is spending a big chunk of drug-company money to tell doctors not to accept large gifts from drug companies in a campaign that critics say smacks of hypocrisy.
The AMA is contributing about $400,000 to the $1 million effort, but most of the balance comes from payments between $50,000 and $100,000 from nine major drug companies.
The AMA says it makes sense to involve the industry in a campaign that’s also designed to inform drug makers about what is considered unethical behavior. But critics question that logic.
``How can anyone believe that they’re engaging in some kind of campaign to fight the perception of unethical behavior by engaging in unethical behavior?’‘ Dr. Sidney Wolfe, director of the consumer-oriented Public Citizen Health Research Group, said Wednesday. ``It’s just outrageous.’‘
Some medical ethicists agree.
``It’s symbolically endorsing the very behavior that they’re trying to caution against,’‘ said Dr. John Lantos, associate director of the University of Chicago’s MacLean Center for Clinical Medical Ethics.
At issue are the myriad freebies, ranging from pens and notepads to free dinners and trips, that some drug makers shower on doctors. Ethicists say the gifts could encourage doctors to prescribe medications that may not be in patients’ best interests.
``Overall they spend billions of dollars trying to influence physicians’ prescribing behavior, and it works,’‘ Lantos said.
AMA policy suggests a limit of about $100 on such gifts and says they should not include things like free trips, hotel accommodations and other personal expenses for doctors attending conferences. Things like work-related pens and notepads are considered acceptable.
``Any gifts accepted by physicians individually should primarily entail a benefit to patients and should not be of substantial value,’‘ the policy says.
Dr. Randolph Smoak, the AMA’s immediate past president, said the campaign was prompted in part by concern that many younger doctors may be unaware of the decade-old policy.
``We’re attempting to not only re-educate physicians but also the marketing forces,’‘ Smoak said, ``so that all those people understand the rules of engagement.’‘
The Pharmaceutical Research and Manufacturers of America, a trade group for most of the nation’s brand-name prescription drug makers, supports the policy, but believes ``it is entirely appropriate to educate physicians about new treatments,’‘ spokeswoman Jackie Cottrell said.
She said her group is informing industry representatives about the policy as part of the campaign.
The AMA on Monday began mailing informational material to doctors, which includes a list of the drug-company sponsors. The campaign also includes a new Web site about the guidelines.
Critics support limiting pharmaceutical industry influence, but question the funding source for the campaign and say it might backfire by influencing doctors to favor the nine companies that are participating.
``Whoever is making decisions over there seems to be just brain-dead,’‘ Wolfe said of the AMA.
He likened the controversy to the AMA’s botched 1997 deal with Sunbeam Corp., in which the association was forced to abandon an agreement to endorse Sunbeam products after an outcry from members and ethicists.
Dr. Jay Jacobson, an AMA member and chief of the medical ethics division at LDS Hospital and University of Utah medical school, agreed that the funding ``seems absolutely paradoxical.’‘
But Jacobson said, ``You have to suspend judgment’‘ and see if the campaign works at curbing unethical behavior.
``This may actually be better than nothing,’‘ he said.
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