BAN ON GIFTS TO DOCTORS SOUGHT: MURRAY TARGETS FIRMS' FREEBIES

Senate President Therese Murray proposed a total ban on all gifts and freebies to doctors from pharmaceutical companies, a move that would make Massachusetts the first state in the country to ban such gifts outright.

The measure is part of a set of healthcare reform measures Murray filed in a bill that also includes requiring all doctors statewide to adopt electronic medical records by 2015, allowing patients to choose nurse practitioners as primary care providers, and forcing public reviews of any insurance company efforts to boost annual premiums by more than 7 percent.

"There's going to be a climate change, and there has to be a climate change; otherwise our healthcare reform will implode, just under the costs," Murray said at a press conference at the University of Massachusetts Medical School yesterday.

The ban forbids the pharmaceutical industry from giving - and doctors, their families or employees from receiving - gifts from drug companies. Gifts include payments, entertainment, meals, travel, honorariums, subscriptions, even a pen with a drug company logo.

The legislation would continue to permit distribution of drug samples to doctors for the exclusive use of their patients. Anyone who violates the ban could be fined $5,000, face two years imprisonment, or both, under the proposal.

Other states have passed laws attempting to limit the pharmaceutical industry's influence. In Minnesota, legislators enacted a ban on gifts in excess of $50 from pharmaceutical companies. In Vermont, legislators have passed laws requiring pharmaceutical company representatives to disclose the dollar value of gifts over $25 to doctors.

The ban on drug and device company gifts to physicians was first proposed in 2005 by state Senator Mark C. Montigny, a New Bedford Democrat, who said by phone that he was "very pleased" to see it included in Murray's proposal. Montigny said he grew concerned about the cost of drugs bought through state-sponsored healthcare programs as chairman of the Senate's Healthcare Committee.

He said he was disturbed to see drug companies hire salespeople including "former beauty queens and cheerleaders" who wine and dine doctors and encourage them to prescribe drugs that may not be the most cost-effective.

"You would not believe the conflict of interest here," Montigny said. "Of all the nasty manipulation that's gone on, there's no more effective group at getting more than they deserve at the expense of the taxpayer than the pharmaceutical industry." He said the state continues to overpay for drugs.

Julie Corcoran, deputy vice president of the Pharmaceutical Research and Manufacturers of America, a trade organization based in Washington D.C., said the industry's sales people are "highly educated and trained by their companies." The group opposes any ban, saying the pharmaceutical industry is already heavily regulated by the Food and Drug Administration. "I'm not aware of any kind of evidence or studies that link promotional or marketing materials with the cost of healthcare," she said.
The proposed ban is also more strict than the current policy proposed by the American Medical Association. That policy bans cash gifts, but allows doctors to receive textbooks, modest meals, and "other gifts that serve a genuine educational function." The association also allows doctors to receive drug samples for personal or family use.

Other provisions in the bill improve primary care access, enhance cost transparency and promote efficiency. In addition to banning gifts, the bill sets up a program to provide physicians with evidence-based, unbiased info about drugs to counter one-sided sales pitches they get from Pharma salespeople (see accompanying story “States Initiate Prescription Drug ‘Unsales’ Campaigns”). The bill prohibits payments for "never events," requires reporting of infections to DPH and sets up Patient and Family Councils in hospitals to ensure that consumers have a voice. Also on the list - required hearings when insurers raise rates more than 7% in a year and expansion of the "Senior Care Options" program. Murray stressed that the legislation goes hand-in-hand with a $1 tobacco tax hike.

-Adapted from “Ban on gifts to doctors sought: Murray targets firms' freebies” By Megan Woolhouse, with material from State House News Service, in The Boston Globe, March 4, 2008, http://www.boston.com/news/local/articles/2008/03/04/ban_on_gifts_to_doctors_sought/ and “Health Reform Phase II: Cost Control- Senate President Murray Introduces Legislation” Health Care For All News -- March 2008.

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