Group to crack down on bribing of doctors

Doctors may need to find another source of funding for their golfing trips.

The International Federation of Pharmaceutical Manufacturers and Associations - a Swiss-based organization that represents international pharmaceutical companies - enacted a new code last week that will help officials monitor drug representatives who, for years, have often offered elaborate gifts in an attempt to influence physicians' drug purchases.

Prohibitions against this sort of behavior are often ignored, according to Frederique Santerre, acting director of Health Care Systems at the IFPMA.

And the Hospital at the University of Pennsylvania has had a comparable policy of its own for six months.

Last July, HUP officials instituted a rule banning doctors from accepting gifts - big and small - from drug representatives.

"Penn is a teaching hospital, and some of our academic doctors said they wanted to send a better message to our students [and] minimize corruption," said Arthur Caplan, chairman of Penn's Medical Ethics Department.

And even though HUP has never experienced major bribery issues among its faculty, according to HUP officials, other studies have found that pharmaceutical companies are nevertheless notorious for attempting to sway doctors.

Pharmaceutical companies spend anywhere between $8,000 and $13,000 per physician annually, according to a study published by the American College of Physicians-American Society of Internal Medicine in 2001.

Pharmaceuticals spend money on everything from meals at conventions and office supplies emblazoned with drug names, to plane tickets for conferences held in exotic locations.

But even smaller gifts can present a problem, officials say.

"Look - if it's small gifts, what difference does it make? But in fact, we looked at all the literature and it became clear to us that little gifts really made a difference," Caplan said.

The study also found that, in general, for every doctor currently practicing medicine, there are 11 pharmaceutical representatives trying to influence him.

Santerre noted that the new code was prompted by growing concerns from drug companies themselves about the potentially unethical gift-giving practices of their representatives.

"This kind of behavior can't be allowed anymore," she said.

Caplan added that doctors who receive free samples or gifts from pharmaceutical representatives are more likely to use them and want to continue using them in the future.

This can be a problem if the medication in question is not necessarily the best for the patient, he said.

For now, HUP doctors seem to agree that HUP has been right in its decision all along.

"There's pretty extensive literature showing that doctors consistently underestimate the effect of gifts on their behavior," said Peter Reese, a HUP post-doctoral fellow.

Please note All comments are eligible for publication in The Daily Pennsylvanian.