As everyone waits for the House to take action on the cost control bill, a WBUR story yesterday brought good news and bad news. The good news is that the House will likely take action on the bill shortly; the bad news is that the pharma gift ban may be absent from the bill that comes out of the House. Will the House cave to industry pressure and leave out this critical provision put forth by the Senate President? We sure hope not.
The evidence is clear – in order to effectively control costs, we must ban pharmaceutical gifts to prescribers. Countless studies have found that gifts of all sizes inherently impact prescribing decisions leading to unnecessary prescribing of the most expensive and least tested drugs and, in turn, higher health care costs and lower quality of care. Banning pharmaceutical gifts to physicians isn’t a silver bullet to our cost control problem, but it is a piece of the solution.
The evidence also shows that we can not rely on the industry to self regulate. Mandatory disclosures of gifts made in other states show that since the release of an industry internal code of conduct (“the PhRMA Code”) in 2002, pharmaceutical industry gifts and payments to physicians did not decline, but instead increased. In fact, in response to questions by Senator Moore at the legislative hearing on the cost control bill, PhRMA was not able to point to a single example of a violator of the industry standards being sanctioned.
This data is corroborated by Shahram Ahari, former Eli Lilly sales representative. According to Ahari, it is common for sales representatives to give gifts in violation of the Code. The problem goes deeper than lack of enforcement, though. Even if the standards were adequately enforced, they’re not sufficiently strong. The PhRMA Code, which sets the industry standards, allows gifts of up to $100 and meals. The result of the weak standards and weak enforcement is continued offering of inappropriate gifts to our health care providers. According to Ahari, pharmaceutical sales reps continue to give gifts including bottles of alcohol, tickets to entertainment events, electronics and even gym memberships.
The industry has been left to self-regulate for years and the result has been inappropriate gifts and payments, undue influence, higher costs and compromised quality of care. The House must follow the Senate’s lead and seize the opportunity to institute a much needed statewide ban on pharmaceutical gifts. If they fail to do so they will be leaving the fox to guard the hen house.
Lisa Kaplan Howe