Association of American Medical Colleges proposes ban on 'pharma' gifts to physicians, staff, medical students

Apr 28 2008

All 129 U.S. medical schools should not allow pharmaceutical and medical device companies to provide food, gifts and travel to physicians, faculty members and students, according to a report released on Sunday by the Association of American Medical Colleges, the New York Times reports.

According to the report, drafted by a task force formed by AAMC in 2006, such "forms of industry involvement tend to establish reciprocal relationships that can inject bias, distort decision-making and create the perception among colleagues, students, trainees and the public that practitioners are being 'bought' or 'bribed' by industry." Roy Vagelos, a former Merck CEO, chaired the task force, which also included the CEOs of Pfizer, Eli Lilly, Amgen and Medtronic.

The report recommends that medical schools "strongly discourage participation by their faculty in industry-sponsored speakers' bureaus," in which physicians receive payments to promote the benefits of medications and medical devices. In addition, the report recommends that medical schools establish centralized systems for the acceptance of medication samples from pharmaceutical companies or develop "alternative ways to manage pharmaceutical sample distribution that do not carry the risks to professionalism with which current practices are associated." Medical schools also should audit independently accredited medical education seminars led by faculty members "for the presence of inappropriate influence," according to the report.

Most medical schools follow the recommendations of AAMC, although they can decline to adhere to them. According to the Times, only a "handful of medical schools presently bar faculty members from serving on speakers' bureaus, so if this recommendation is widely adopted, it could transform the relationship between medical school faculty and industry, and it could change substantially the way medical education is routinely delivered." Many medical school faculty members have opposed restrictions on participation in speaker bureaus, as well as limits on medical samples from pharmaceutical companies.

Comments

Rob Restuccia -- executive director of the Prescription Project, a not-for-profit group that seeks to prevent conflicts of interest in medicine -- said that the recommendations in the report would change medical education. He said, "Most medical schools do not have strong conflict-of-interest policies, and this report will change that."

Vagelos said that the recommendations in the report likely will face opposition from some medical school faculty members. In addition, he said, "The outcome of this for the industry is that those companies that are strong in science will always be welcome at medical colleges, and others won't."

Pfizer CEO Jeffrey Kindler and Eli Lilly CEO Sidney Taurel -- both members of the task force -- in the report wrote that they oppose the recommendation to restrict participation by medical school faculty members in speaker bureaus. They wrote, "We continue to believe that these types of programs, which are subject to clear regulations regarding their content, can be worthwhile educational activities."

David Beier, an Amgen senior vice president, wrote a letter that endorsed the recommendations in the report but questioned some of the language "because we have a different view about the accuracy concerning representations about the motives of the participants in industry-academic interactions."

Ken Johnson of the Pharmaceutical Research and Manufacturers of America said that the group will review the report. He added, "Providing physicians -- and medical students -- with timely, accurate information about the medicines they prescribe clearly benefits patients and advances health care throughout the United States" (Harris, New York Times, 4/28).

The report is available online (.pdf).