gift ban


Council Vote On Pharma Gifts Weakens Ban: How Much Is A ‘Modest’ Meal?


(Updated: 4:22 p.m.)

The Boston Herald reports that the state’s Public Health Council has approved regulations that weaken the state’s ban on pharmaceutical industry gifts and fancy dinners for doctors.

The decision disappoints the non-profit Health Care For All. On its blog, it says:

Despite widespread opposition among Council members, the Public Health Council voted this morning to enact final regulations on meals provided by the drug and device industry to doctors and other prescribers. The regulations approved today keep intact the expansive, subjective definition of “modest” meals, as whatever a doctor would order on his or her own. The regulations also permit drug sales teams to provide free alcoholic beverages to doctors at drug industry “educational” sessions. Although a number of motions were made to ban alcohol and limit the amount spent on meals, they were not voted on during the somewhat chaotic process of discussing the regulations. (see the Boston Herald coverage)

We were deeply disappointed by the outcome, which ignored extensive evidence that pharma industry marketing practices distort prescribing and raise drug costs for everyone.

To recap: In 2008, the state passed a sweeping ban prohibiting drug companies from giving gifts and fancy dinners to doctors. This summer, after some major lobbying from the restaurant and pharmaceutical industries, the ban was partly repealed to allow “modest meals and refreshments” served “in a venue and manner conducive to informational communication.”

Of course, modest is in the eye of the beholder. Personally, I consider McDonald’s and Burger King to be modest, maybe all the way up to Appleby’s and Olive Garden. What do you think?

Health Care for All argues: Continue reading

Do You Like Your Docs Shaken Or Stirred?

Medical students and consumer advocates protest against the relaxation of a gift ban

Opponents of new regulations that would relax restrictions on drug and medical device makers’ ability to wine and dine doctors are making their point by offering “drinks and lobsters” to folks at the State House today.

Here are details of the event from the advocacy group Health Care For All:

Under the slogan, “Doctors shouldn’t be SHAKEN or STIRRED”, medical students from Harvard Medical School and Boston University School of Medicine will gather at the State House to offer “drinks and lobsters” to anyone on their way to meet with the Governor or other state officials. The message they wish to convey? “The Administration and Department of Public Health (DPH) think that alcohol and fancy meals are conducive to educating medical professionals — it must be good for educating government officials, too.” The group will deliver a sign-on letter to the Governor with signatures from over 100 medical students and other medical professionals urging that the DPH regulations be amended. Continue reading

Study Finds ‘Sunshine’ Laws Have Little Effect On Prescribing

The Massachusetts ‘gift ban,’ barring drug- and device-makers from showering doctors with money and meals, was passed way back in 2008, but it remains a live controversy. The House, by my count, has now twice passed repeals of the ban, according to the State House News Service; and it sounds like last week, the Senate once again said no, no repeal, according to Health Care For All.

So I figure this new study just out from the Colorado School of Public Health and Harvard will serve as fodder in the ever-swirling debate. The headline: “New federal disclosure law will have little impact on drugs prescribed.”

And my provincially slanted summary: Maine passed a law in 2004 that required that gifts to doctors be publicly disclosed (which the Massachusetts gift ban also does). Nearby New Hampshire and Rhode Island have not. The researchers compared prescribing of two types of drugs — statins and antidepressants — in which gifts seemed likely to influence doctors to prescribe more expensive brands. And they found extremely little difference made by the public disclosure laws.

Conclusion, from lead author Genevieve Pham-Kanter, Ph.D., an assistant professor at the Colorado School of Public Health and a research fellow at Harvard University and Massachusetts General Hospital: “”If the policymakers who passed these measures were hoping for a deterrent effect they may be disappointed.”

(Of course, if you’re a gift-ban backer, your conclusion may be: It’s not enough to disclose; you have to ban…And the finding makes intuitive sense to me: Have you ever looked up your doctors’ gifts? No? Me neither. So why should your doctor care if they’re listed somewhere?)

More from the press release: Continue reading

AARP Outs Lawmakers Who Broke Pledge On Gift Ban

Message to lawmakers: Don’t cross the AARP and expect to get away with it.

The influential advocacy group for the over-50 crowd today delivered letters to 14 state representatives to remind them of the “campaign promises they made to maintain and fund the prescription drug gift ban and disclosure law.”

Happy to name names, the AARP put out a list of the reps who voted to repeal the 2008 law which bans drug companies from offering gifts, wine, lavish dinners and other freebies to physicians. The repeal passed in the House overwhelmingly Tuesday with bipartisan support as part of a budget plan. Here’s the full list of AARP promise-breakers — each of whom had signed a pledge last year to uphold the gift ban and disclosure law:

Paul Adams (R-Andover, 17th Essex District)
Richard Bastien (R-Gardner, 2nd Worcester)
Paul Brodeur (D-Melrose, 32nd Middlesex)
Edward Coppinger (D-Boston, 10th Suffolk)
Gloria Fox (D-Roxbury, 7th Suffolk)
Anne Gobi (D-Spencer, 5th Worcester)
Steven Levy (R-Marlborough, 4th Middlesex)
John Mahoney (D-Worcester, 13th Worcester)
Paul Mark (D-Hancock, 2nd Berkshire)
Tom Sannicandro (D-Ashland, 7th Middlesex District)
Paul Schmid (D-Westport, 8th Bristol District)
Ellen Story (D-Amherst, 3rd Hampshire District)
Benjamin Swan (D-Springfield, 11th Hampden District)
Cleon Turner (D-Dennis, 1st Barnstable District)

The AARP, which represents more than 800,000 members in the state, says in its 2010 Voters’ Guide that each representative responded to a specific question on prescription drug affordability and also indicated support for the gift ban law.

Today’s letter, from State Director Deborah Banda and State President Linda Fitzgerald reads, in part:

AARP members were counting on you to keep your campaign promise. In the AARP Voters’ Guide, published in October 2010, you responded to a specific question on prescription drug affordability and indicated you supported maintaining and funding the prescription drug gift ban and disclosure law. But, Tuesday you voted in support of Amendment No. 230 to repeal the law. AARP members want to know why you changed your position.

Lobster Risotto and Lobbying: More On Doctors Paying For Their Own Food

Restaurants Just Say No to doc gift ban

Davio’s, the pricey Italian steakhouse known for its Kobe beef meatballs, lobster risotto and hand-rolled potato gnocchi, seems to have made a seamless transition from haute cuisine to hardball politics having successfully lobbied (with help from others, of course) the state House of Representatives to repeal a 2008 ban on drug companies giving gifts and fancy dinners to doctors.

The House overwhelmingly voted to repeal the ban as part of an “economic development” bill (they tried the same tactic last year but were ultimately thwarted by the state Senate). Insiders are cautiously optimistic that the Senate will once again block any repeal of the ban when they vote on a budget, but apparently the pharmaceutical industry has made some inroads, so at this point nothing is certain.

The chutzpah of Davio’s, the Massachusetts Restaurant Association and the drug industry pushing the repeal is pretty impressive. But according to consumer advocates from Health Care For All, several of the restauranteurs assertions about the economic decimation that has come from the gift ban, may be, well baloney:

Here, courtesy HCFA’s Brian Rosman, is a bit of truth squadding:

1. Claim: “Restaurants provide an important setting for all types of meetings to take place and shouldn’t be excluded as a venue from hosting educational meetings and presentations.”

Truth: The statement is false, and restaurants are not excluded by law. The law allows “educational meetings” at restaurants, as long as the doctor pays his or her own way. If these sessions are for the benefit of the physicians, why can’t the doctor pay for the meal, and listen to the educational presentation from the drug company? Why do premium payers have to cover the meal?

2. Claim: “The mislabeled ‘gift ban’ has been devastating to restaurants and thousands of middle-class employees.”

Truth: The statement is false. State figures conclusively show that the restaurant industry has been booming. Last year was their best year ever, and so far this year is topping last. Devastating? There’s no evidence of that. In any case, every dollar spent on drug industry marketing on restaurant meals is a dollar added to the cost of health care in America. So why should our health care dollars prop up restaurant meals for well-to-do physicians?

As stated in Billy Rubin’s blog:

For those who have been trapped in solid ice since, say, the mid-1930s and the heyday of the Henry Cabot Lodges and William Morgan Butlers, in Massachusetts, the House belongs to the Democratic party. So how does such a law that seems to once again encourage the wink-wink nudge-nudge relationship between docs and the pill-pushers–particularly when the same legislative body clamps down on labor’s bargaining rights in an effort to rein in spending costs–get passed?

Amazingly, the answer appears to lie in…the dining & entertainment lobby.