Legislative Director, MASSPIRG
Legislative Director, MASSPIRG
BOSTON–Leading consumer, health care and senior and community advocates strong opposition to regulations approved today by the Department of Public Health.
The regulations implement a law passed over the summer to relax state restrictions on meals provided by pharmaceutical and medical device companies to doctors. Under the previous law, meals may not be provided unless in a clinical setting. The amendment permits “modest meals and refreshments” to be offered at educational programs outside of a health care setting, such as a restaurant. The regulation approved today ignored the legislative direction to limit permitted meals to those considered modest, and instead defined “modest” as “similar to what a health care practitioner might purchase when dining at his or her own expense.”
As a result, drug companies are free to ply doctors with lavish multi-course meals and drinks, paid for by pharmaceutical industry marketing budgets, and ultimately tacked on to the price of prescriptions.
“Our expectation was that DPH would establish a concrete monetary limit to define the term ‘modest,’ and we felt strongly that these meals should exclude alcohol. Instead, the proposed regulations have no monetary restriction, and permit the provision of alcohol,” said Amy Whitcomb Slemmer, Executive Director of Health Care For All. “The proposed regulations will take us back to the days of pharmaceutical and device representatives wining and dining our doctors.”
“The DPH’s proposed regulations not only fail to meet the letter of the law passed by the legislature, they fail to meet a basic common sense interpretation of the law. The legislature passed a law in July that limited big pharma’s ability to wine and dines physicians by only allowing ‘modest meals’ in an environment ‘conducive to education,'” said Deirdre Cummings, Legislative Director of MASSPIRG. “Barring and restricting the drug industry from giving gifts – including fancy dinners, to physicians and other prescribers of prescription drugs protects consumers by limiting the aggressive, biased marketing tactics of drug companies and reduces our escalating drug costs.”
Health Care For All (HCFA) and the Massachusetts Prescription Reform Coalition (MPRC) submitted comments to DPH focused on preserving the sanctity of the doctor-patient relationship. The changes run contrary to the widely-accepted recognition by the medical community that providing gifts, such as payment for meals, violates medical ethics and goes against the best interests of patients and the medical community at large. In fact, all Massachusetts medical schools and major teaching hospitals have enacted policies that prohibit gifts from industry, including all onsite industry-sponsored meals, with some exceptions for meals associated with CME events.
“AARP believes relationships between drug companies and doctors should be transparent and free from conflicts of interest,” said Bill Johnston-Walsh, state director of AARP Massachusetts, which serves more than 800,000 members age 50 and older in the commonwealth. “Today’s decision by the Public Health Council to approve regulations that will further weaken the state’s Prescription Drug Gift Ban Law, ultimately puts the best interest of patients at risk.”
The regulations presented by DPH and approved by the Public Health Council today did not include any of the recommendations made to protect patients. Instead, the proposed language paves the way for increased marketing money that will be spent in order to influence prescribing behavior, and will affect consumers and taxpayers as we all ultimately pay the price for these biased marketing practices that raise health care costs.
“These new regulations mean Massachusetts will plummet from its place as a national leader in protecting the public from excessive and inappropriate marketing practices of drug companies that influence physician prescribing and patient care, thereby setting a bad precedent for all other states. Not only do the regulations ignore legislative intent, but they do away with the required disclosures of payments to providers, such as nurse practitioners and physicians assistants, who are now key to primary care in MA and thus increasingly the target of industry promotions,” says Marcia Hams, Director of Prescription Access and Quality at Community Catalyst.
DPH will hold a public hearing on the regulations on Friday, October 19 and will be accepting written comments. HCFA and MPRC will be working relentlessly for the rejection of the adopted regulations and will be once again submitting recommendations aimed to maintain the integrity of the physician-patient relationship.