In lieu of an abstract, here is a brief excerpt of the content:

5 The Industry’s Code: Not Good Enough e “PhRMA Code on Interactions with Healthcare Professionals ,” published in 2002, is a very significant document. It represents an acknowledgment, on the part of the industry, that laws and governmental regulations are not sufficient to provide full guidance to what is good ethical practice. It is a recognition, in effect, that some of the concerns that have been raised about marketing practices need to be addressed. With this Code, the industry has made a public ethics statement, identifying the kinds of activities that it finds acceptable and the kinds of activities that it thinks are not appropriate. e Code, included at the end of this chapter, merits careful study and reflection. It provides an opportunity to understand the industry’s own view of its ethical responsibilities in marketing to healthcare professionals and in related interactions with them. It also provides an opportunity to assess the adequacy of the guidelines , to determine how well they address the concerns that have been raised and whether they represent the approach to marketing that is required by a commitment to good healthcare, good science , and good ethics. They [the PhRMA guidelines] would limit the value of gifts to less than one hundred dollars, and require that the gifts be relevant to patient care—like textbooks. But the guidelines don’t . . . bother to tell us why drug companies should be giving gifts to doctors in the first place, when the costs will just be added on to drug prices. The guidelines also permit more extravagant gifts and junkets if they can be construed as furthering an educational or research purpose.1 67 The Industry’s Code WHAT THE CODE INCLUDES AND DOES NOT INCLUDE Keeping in mind the range of concerns identified in chapter 3 and the ethical responsibilities to healthcare professionals discussed in chapter 4, it is useful to begin with a few observations on the types of practices that the Code addresses, how it addresses these, and what the Code does not include. 1. e Code does not propose any fundamental changes in the nature , purpose, or frequency of interactions with healthcare professionals . Rather, it delineates between appropriate and inappropriate behaviors within these interactions, primarily by identifying the types of gifts and other inducements that may and may not be offered to healthcare professionals. As expressed in the preamble and in section 1, the Code is seen as directly related to the industry’s mission of helping patients live longer and healthier lives through the development and marketing of medicines. e purpose of the Code is to clarify the ethical boundaries needed to keep the focus on benefiting patients: is Code is to reinforce our intention that our interactions with healthcare professionals are to benefit patients and to enhance the practice of medicine. e Code is based on the principle that a healthcare professional’s care of patients should be based, and should be perceived as being based, solely on each patient’s medical needs and the healthcare professional’s medical knowledge and experience. (preamble) It is not surprising, but it remains worthy of note, that the industry’s response to the concerns that have been raised about how marketing to physicians might be affecting medical practice is to repeat its belief that such marketing contributes to better patient care. e approach taken in the Code is much more like the approach taken by the AMA (that there is a need to address some specific questionable practices in the industry’s relationships with physicians and other healthcare professionals) than the approach taken by those more critical of the industry (that there is a need to recognize that the very nature of pharmaceutical marketing to professionals threatens professional objectivity and good 68 Marketing to Healthcare Professionals healthcare). e Code seems, therefore, to be more a defense of the status quo than a reform document. e Code recognizes that a variety of different non-research interactions—informational presentations sponsored by the company , education provided by others that the company supports financially, the hiring of healthcare professionals as consultants, the training of healthcare professionals to be speakers at company programs, the provision of scholarships for educational programs, and the gifts and social amenities provided to professionals—all relate to the company’s marketing efforts. Important ethical issues are addressed in regard to each, but the Code does not call for any reduction in the number or types of interactions. 2. e key method used to establish limits in...

Share