Revised PhRMA code bans future drug pens, mugs, etc..

[ethyl]

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http://www.pr.com/press-release/94943

Revised PhRMA Marketing Code Calls for More Educational Materials for Health Care Providers and Staff - Anatstat Health Education Can Help

The newly revised PhRMA Code, which will take effect in January 2009, states that “interactions between company representatives and healthcare professionals should be focused on informing the healthcare professionals about products, providing scientific and educational information, and supporting medical research and education.” Anatstat Health Education can help.

Flemington, NJ, July 13, 2008 --(PR.com)-- On July 10, 2008, the Pharmaceutical Research and Manufacturers of America (PhRMA) released the most updated PhRMA Code on Interactions with Healthcare Professionals, expanding on the 2002 version.

The newly revised PhRMA Code, which will take effect in January 2009, states that “interactions between company representatives and healthcare professionals should be focused on informing the healthcare professionals about products, providing scientific and educational information, and supporting medical research and education.”

The revised Code “prohibits distribution of non-educational items (such as pens, mugs and other “reminder” objects) to healthcare providers and their staff.” In addition, it prohibits company sales representatives from providing restaurant meals, but allows them to provide meals in conjunction with educational presentations in the office.

Since 1995, Anatstat Health Education Media (Flemington, NJ) has been helping the pharmaceutical industry create educational tools and custom teaching anatomical models for health care providers (HCP) and their patients. Anatstat has expanded their services to include state-of-the-art focus group facility that ensures that these tools communicate value, education, disease state awareness and assist patients make fully informed decisions about the management of their health.

Marc Sirockman, Anatstat’s General Manager, commented that “Anatstat is a provider of unique, tangible and tactile teaching tools that build brand equity at the point of care. For the last 13 years, we have specialized in creating compelling patient education tools, that leverage health education media principles, incorporate adult learning strategies and simplify complex health topics with visually engaging medical illustrations. We have created and delivered over 900 custom health education tools that have been award winners. We pride ourselves in providing creative and innovative solutions that solve brand challenges. Each of our health and patient education tools is research- based, and supports the objectives of the sales representatives, the HCP, the patient, supporting pharmaceutical brand strategies.”

 

[Priapism321]

Good, we can afford our own pens (and for that matter, tissue, clocks, note pads, tablet spatulas, staplers, tape dispensers, etc., etc., etc.), and not shamelessly promote overpriced, overhyped products to our patients/family/support staff at the same time.

 

[GatorRxGirl]

But I like using my Viagra pen.

 

[117296]

But I like using my Viagra pen.

A Viagra pen would be much more hilarious if it were curved when not in use and straight when in use....albeit too much work for a pharmaceutical company. Or if it were shaped to model the body part it affects. The latter would lead to use by (mostly) female health professionals only...and many harassment lawsuits.

Damn you sexual harassment!!!

While on the topic of pens, I wish my Rozerem pen had a small beaver, Abe Lincoln or scuba diver floating around the inside of it.

In all seriousness, I vote to get rid of the pens. Get rid of drug reps altogther.

 

[187502]

While on the topic of pens, I wish my Rozerem pen had a small beaver, Abe Lincoln or scuba diver floating around the inside of it.

People might take the beaver the wrong way...

 

[117296]

People might take the beaver the wrong way...

Which would be ironic in itself given that it is a sleeping pill.

But honestly, would doctors and pharmacists cease to write or go hungry from no more free meals? I highly doubt it.

Speaking of free meals, the bum that regularly panhandles at the entrance of the parking lot to our store came into to complain that another bum had gotten to her panhandling spot before she could.
Sweet, sweet revenge.

 

[Priapism321]

A Viagra pen would be much more hilarious if it were curved when not in use and straight when in use....albeit too much work for a pharmaceutical company. Or if it were shaped to model the body part it affects. The latter would lead to use by (mostly) female health professionals only...and many harassment lawsuits.

Here is something close to what you describe, although it is vardenafil rather than sildenafil.

http://drugreptoys.blogspot.com/2006/10/levitra-pen.html

http://photos1.blogger.com/blogger/6296/1920/1600/levitra opening.jpg

You press a button, and the pen "rises" to the occasion (ie, writing).

 

[nnguyenc]

wtf?

that's how i learn my brand/generic from all the pens, mugs, etc i have
around my house....IT IS EDUCATIONAL

 

[Priapism321]

wtf?

that's how i learn my brand/generic from all the pens, mugs, etc i have
around my house....IT IS EDUCATIONAL

If that is how you have to learn the names of drugs, you must go to a pretty ****ty pharmacy school...just sayin'

(Sarcasm is hard to detect on the internet, but hopefully the entire post above was meant to be taken that way)

 

[GatorRxGirl]

Does that pen vibrate?

 

[twester]

We'll still have pens. It's my company's policy that we don't take stuff from drug reps, but we do it anyway. Pharmacies make more money from generic products (the margin is much greater), so it's not likely a prescriber is going to call us and we'll try to talk them into Ultram or Xanax DAW instead of the more profitable tramadol or alprazolam.

The pens have absolutely no influence. The clock says Aciphex on it, but I really only care when it's hands say 5:30 (I haven't dispensed more than one Aciphex script in months anyway). I kind of like the goofy promo stuff. I think this regulation will encourage pharmaceutical companies to reign it in a bit, but I hope I can still at least get pens.

And, yeah, what would my kitchen be without the Celebrex mug and the Cellcept thermos among the many other exotic and unknowable drug advertisements? My friends are continually amazed as I explain the MOAs of the myriad drugs represented on my breakfastware. Some call me cheap, but I say I'm pragmatic (and slightly entertaining).

Now the "educational" sessions with the $40-a-plate plastic-food dinners are another issue (those will still be allowed). I see there's one coming up in my area for osteoporosis (it's even open to techs). I know that I may get a few minutes of the pathophysiology of osteoporosis, but the majority of the presentation is going to be a drug company-backed study with an n=450 showing that their once monthly name-brand wonderceutical will accomplish for world peace what 60 years of the United Nations have not. The presenter probably will earn a few thousand bucks. That's wrong and I will not be attending.

 

[Priapism321]

The pens have absolutely no influence. The clock says Aciphex on it, but I really only care when it's hands say 5:30 (I haven't dispensed more than one Aciphex script in months anyway).

Unfortunately for what you think, every shred of research looking at this unequivocally refutes the above statement. Perhaps it doesn't have an influence in a retail pharmacy simply because it probably can't have much of an influence, but it is still whorish, because you know who pays for those bright, shiny pens ultimately? The patient, when you are ringing up their 30 day supply of rabeprazole for a cool $160 as you initial their bottle with the pretty AciPhex pen you got from the salesman.

If pens and trinkets have no influence, I would love you to explain to me why the companies spend millions of dollars handing them out annually. You don't think there is a return on investment? Please.

 

[PharmDstudent]

Priapism321- You crack me up! Nearly every drug that you mention on this forum is a chemical name, not a brand name. Honestly, I've never heard of anyone referring to Viagra as sildenafil. It must be a hospital thing...

I think if there was a nerd contest, you would win the gold medal. 😀

 

[twester]

Unfortunately for what you think, every shred of research looking at this unequivocally refutes the above statement. Perhaps it doesn't have an influence in a retail pharmacy simply because it probably can't have much of an influence, but it is still whorish, because you know who pays for those bright, shiny pens ultimately? The patient, when you are ringing up their 30 day supply of rabeprazole for a cool $160 as you initial their bottle with the pretty AciPhex pen you got from the salesman.

If pens and trinkets have no influence, I would love you to explain to me why the companies spend millions of dollars handing them out annually. You don't think there is a return on investment? Please.

Can you reference any of this research? I used to be as rabid as you about the pens and the sticky pads. I see now that it has no influence. You do realize that a great many (but not quite most) of the patients in a retail pharmacy have insurance? So the patient isn't paying - the insurance company is. And if there's a generic available - insurance doesn't pay for brand ever. In fact, most insurance won't pay for brand if there's a generic in the same class - the generic is preferred. There are exceptions, but few of them.

Patients without insurance don't pick up scripts filled for brand names because they cost too much. That's not the fault of a few pens and googaws. It's the fault of the manufacturer that sets the price.

The people most influenced by all this marketing are the prescribers, but they're quickly finding out that the effort of calling an insurance company for a prior authorization is not worth plastic food or a slick pen with gel filler followed by a call from every pharmacy in town. So they just write for the generic or the brand with a generic substitution.

Pens are not influential.

 

[Priapism321]

That's not the fault of a few pens and googaws. It's the fault of the manufacturer that sets the price.

And you do not think the money that manufacturers spend on promotion (which is approximately 3 times the amount spent on research and development) drives up drug prices in this country?

Give me a second on some references.

 

[twester]

And you do not think the money that manufacturers spend on promotion (which is approximately 3 times the amount spent on research and development) drives up drug prices in this country?

Give me a second on some references.

You need to go back and read my posts. I did protest the dinner to which you've never been invited at a very expensive generic chain restaurant. That pen cost $0.05 at say, 2000 produced, for a total of $100. The dinner costs thousands - maybe into the 5-digits.

The numbers you might have for marketing for the pharmaceutical industry are from TV advertising - which, you might know is VERY expensive.

You also need to address an entire post - not just the line that you can make a snippy one-line answer to.

I'm still waiting for you to reference your "research".

Fail.

 

[Priapism321]

I'm still waiting for you to reference your "research".

Fail.

Start here, there is a good section on "The Myth of the Small Gifts"

http://jama.ama-assn.org/cgi/content/abstract/295/4/429

And here some other references:

http://www.ncbi.nlm.nih.gov/sites/entrez

http://www.ncbi.nlm.nih.gov/sites/entrez (has to do with receiving educational books as small gifts)

It seems that I am the only one who can ever produce evidence to support my views on this site, so I will now offer you the opportunity to furnish some credible research showing that gifts (pens, lunches, books, etc.) have no effect on decision-making. It is simply not human to not want to reciprocate when someone does something nice for you, no matter the magnitude of the gesture. Physicians/other health care professionals are subject to the human condition, no matter how much anyone would like to deny it.

 

[twester]

Start here, there is a good section on "The Myth of the Small Gifts"

http://jama.ama-assn.org/cgi/content/abstract/295/4/429

And here some other references:

http://www.ncbi.nlm.nih.gov/sites/entrez

http://www.ncbi.nlm.nih.gov/sites/entrez (has to do with receiving educational books as small gifts)

It seems that I am the only one who can ever produce evidence to support my views on this site, so I will now offer you the opportunity to furnish some credible research showing that gifts (pens, lunches, books, etc.) have no effect on decision-making. It is simply not human to not want to reciprocate when someone does something nice for you, no matter the magnitude of the gesture. Physicians/other health care professionals are subject to the human condition, no matter how much anyone would like to deny it.

Your citations reference physicians (the one's that worked at least)

You're buying into propaganda. There's been an ethical debate that small gifts obligate people to return the favor for decades. How does a pharmacist do that with a pharmaceutical company? I can't come up with a scenario for that - and I know there's been no research into that for that reason.

Prescribers are the people most affected by gifts. You'd be amazed at what prescribers are offered. The gifts are not small. I know a family practice Doc that received $5000 to sit in on a conference call and take a survey (oh, and attend a "seminar" in Bermuda). And you're begruding a pharmacy a few pens at a few cents each? Are you serious?

Can someone explain how I would be influenced by a dinner, a pen, or a thermos. I don't prescribe and have no influence in the process. This rule is meaningless (especially because it allows very expensive "education" dinners).

I'm sorry you're feeling persecuted by me, Overhard Penis Syndrome (speaks to credibility, Your Honor). But you're just spouting what they fed me in my Ethics course. You show no evidence of critical thinking whatsoever. "Fail" is a harsh word - I apologize for using it. But there's no logic in your argument.

 

[PharmDstudent]

At least the restaurant meals are a no-no. 😉 I would imagine that the limitations of office dinners is pretty profound. How many people, excluding clinical pharmacists , want to stay on the job longer than they have to?

Then again, the quickest way to a man's heart is through his stomach... 😍

 

[Priapism321]

Your citations reference physicians (the one's that worked at least)

You're buying into propaganda. There's been an ethical debate that small gifts obligate people to return the favor for decades. How does a pharmacist do that with a pharmaceutical company? I can't come up with a scenario for that - and I know there's been no research into that for that reason.

Prescribers are the people most affected by gifts. You'd be amazed at what prescribers are offered. The gifts are not small. I know a family practice Doc that received $5000 to sit in on a conference call and take a survey (oh, and attend a "seminar" in Bermuda). And you're begruding a pharmacy a few pens at a few cents each? Are you serious?

Can someone explain how I would be influenced by a dinner, a pen, or a thermos. I don't prescribe and have no influence in the process. This rule is meaningless (especially because it allows very expensive "education" dinners).

I'm sorry you're feeling persecuted by me, Overhard Penis Syndrome (speaks to credibility, Your Honor). But you're just spouting what they fed me in my Ethics course. You show no evidence of critical thinking whatsoever. "Fail" is a harsh word - I apologize for using it. But there's no logic in your argument.

Not sure why the abstract links failed to work, but they are referenced in the JAMA article that works on my end. Social science research has shown over and over again that small gifts instill a perhaps subconscious debt to reciprocate, that is a fact. I already stated that I doubt retail pharmacists can be substantially "influenced," but I think it has more to do with their lack of ability to influence. I also stated that it is embarrassing that pharmacists accept pens and trinkets as patients struggle to pay for brand name medications that are unnecessarily prescribed due to over promotion (your argument about insured patients, to me, is crap, someone is footing that bill, and when it is the government, it is me). I know several pharmacists who have substantial influence on prescribing behaviors, we must run in different circles (I have previously posted about a pharmacist who received greater than $80,000 from pharmaceutical manufacturers in the course of two years, obviously they felt he may be able to influence something).

On the other hand, you have failed to produce anything substantive to tell me that small gifts do not influence behaviors. Why do pharmaceutical manufacturers give this stuff out, if you think it is out of their kindness of their hearts, because poor Twester cannot afford his own writing utensil and time piece, you are sadly mistaken sport.

I think an Ethics course would be beneficial to most health care professionals, apparently you were not listening hard enough.

 

[Priapism321]

And, by the way, this new "code" is a joke, Daniel Carlat does a good job at reading between the lines:

http://carlatpsychiatry.blogspot.com/2008/07/phrmas-new-code-secret-documents.html

 

[twester]

At least the restaurant meals are a no-no. 😉 I would imagine that the limitations of office dinners is pretty profound. How many people, excluding clinical pharmacists , want to stay on the job longer than they have to?

Then again, the quickest way to a man's heart is through his stomach... 😍

I am invited to a restaurant meal at Magiano's (sp?) in Denver. I will not attend. The topic is "Osteoporosis". The presenter is a prominent physician on the faculty at CU School of Medicine. The company name is withheld by me. Restaurant meals are not prohibited as long as there's an "educational" component and I think that's wrong given that the topic of the dinner is really this company's product.

Can I at last have a pen, Govn'r?

 

[PharmDstudent]

I was invited to a steakhouse dinner for interns. It was not sponsored by a drug company, but the company did sell drugs. 😉

I didn't go for one obvious reason- I'm a vegetarian!

 

[twester]

Not sure why the abstract links failed to work, but they are referenced in the JAMA article that works on my end. Social science research has shown over and over again that small gifts instill a perhaps subconscious debt to reciprocate, that is a fact. I already stated that I doubt retail pharmacists can be substantially "influenced," but I think it has more to do with their lack of ability to influence. I also stated that it is embarrassing that pharmacists accept pens and trinkets as patients struggle to pay for brand name medications that are unnecessarily prescribed due to over promotion (your argument about insured patients, to me, is crap, someone is footing that bill, and when it is the government, it is me). I know several pharmacists who have substantial influence on prescribing behaviors, we must run in different circles (I have previously posted about a pharmacist who received greater than $80,000 from pharmaceutical manufacturers in the course of two years, obviously they felt he may be able to influence something).

On the other hand, you have failed to produce anything substantive to tell me that small gifts do not influence behaviors. Why do pharmaceutical manufacturers give this stuff out, if you think it is out of their kindness of their hearts, because poor Twester cannot afford his own writing utensil and time piece, you are sadly mistaken sport.

I think an Ethics course would be beneficial to most health care professionals, apparently you were not listening hard enough.

You believe everything every pharmacist tells you? You're a fool. That $80,000 was a figment of his imagination. Unless he was on a hospital formulary board. Do tell! Disciplinary action awaits!

I did well in my Ethics course, even having and expressing the opinions I have. Good luck in yours.

The Lovasa pen in my pocket doesn't influence me to do anything. We still send patients to the OTC aisle. The Ultram pen I think writes really slick, still transcribes tramadol scripts.

You're being really obtuse. Sorry - we disagree.

 

[RxWildcat]

Does that pen vibrate?

 

[Priapism321]

You believe everything every pharmacist tells you? You're a fool. That $80,000 was a figment of his imagination. Unless he was on a hospital formulary board. Do tell! Disciplinary action awaits!

The $80,000 was not reported by the Pharmacist, it was reported by pharmaceutical manufacturers secondary to sunshine laws in the state. So, if it was voluntary reporting, it was probably an underestimate. We can disagree, but I wish you could come up with one reason the pharmaceutical manufacturers spend so much time giving the stuff out if it has no influence whatsoever. I repeat, it is not a benevolent act for the good of anyone, and the pharmaceutical industry does nothing that does not result in a net gain on their end. And I am not saying that is a bad thing, just think people who fail to realize that are shortsighted.

 

[GatorRxGirl]

Well if we can't get pens at least we'll get more free food.

 

[twester]

The $80,000 was not reported by the Pharmacist, it was reported by pharmaceutical manufacturers secondary to sunshine laws in the state. So, if it was voluntary reporting, it was probably an underestimate. We can disagree, but I wish you could come up with one reason the pharmaceutical manufacturers spend so much time giving the stuff out if it has no influence whatsoever. I repeat, it is not a benevolent act for the good of anyone, and the pharmaceutical industry does nothing that does not result in a net gain on their end. And I am not saying that is a bad thing, just think people who fail to realize that are shortsighted.

I think pens have some influence on prescribers. They have no influence on retail pharmacies. I've never understood why they bring stacks of them in to us. Even the $20 coupons they bring don't influence their sales - we will always substitute generic and would never call a doc and say, "Why, don't you use Aciphex because we've got this really cool clock?" We're more likely to steer a patient out to the Prilosec when we give the prescriber the opportunity to either OK that change or make a call to the TP plan for a prior auth.

My point, again, was that the new regulations ban pens, but allow other marketing activites disguised as educational events. Pens are (in my eyes) relatively innocuous, expensive dinners and speaking stipends are not at all innocuous.

 

[PharmDstudent]

twester, it's a reminder product.

Let me give you an example:

• Let's say that the Nasonex rep just stopped by to "say hello", and she hands you a pen.
• You thank her for her "kindness", and then she leaves.
• After a period of time passes, a patient comes in with a nasal problem.
• Based on the patient's complaints and her medication history, it seems like her allergy medicines aren't working effectively.
• So, you tell her that she should see her doctor about the nasal problem.
• She responds by asking you what her doctor can recommend, if anything at all.
• You tell her that her doctor should be able to figure this out.
• Dissatisfied with your response, she asks you about Nasonex, because she remembers the bee and the flowers from the commercial.
• So, you tell her that, yes, Nasonex can be used for allergies.
• To top it all off, she sees that you are writing with a Nasonex pen or looking at the Nasonex clock on the wall.
• Your actions verify that you are not against Nasonex, and that in fact, you support the product.
• +1 for the drug company

 

[FruitFly]

The money would be better invested in more research and pharmaceutical support for the indigent.

 

[twester]

twester, it's a reminder product.

Let me give you an example:

• Let's say that the Nasonex rep just stopped by to "say hello", and she hands you a pen.
• You thank her for her "kindness", and then she leaves.
• After a period of time passes, a patient comes in with a nasal problem.
• Based on the patient's complaints and her medication history, it seems like her allergy medicines aren't working effectively.
• So, you tell her that she should see her doctor about the nasal problem.
• She responds by asking you what her doctor can recommend, if anything at all.
• You tell her that her doctor should be able to figure this out.
• Dissatisfied with your response, she asks you about Nasonex, because she remembers the bee and the flowers from the commercial.
• So, you tell her that, yes, Nasonex can be used for allergies.
• To top it all off, she sees that you are writing with a Nasonex pen or looking at the Nasonex clock on the wall.
• Your actions verify that you are not against Nasonex, and that in fact, you support the product.
• +1 for the drug company

You've created a perfect scenario that will never in a million years happen. Nice job. Excellent creative writing skills. As a pharmacist, I won't make drug recommendations to a patient beyond OTC products. Patient has allergies and nothing OTC works? She'll talk to her PCP. The prescriber will "have to figure it out".

The patient never sees me endorse a product, although she might sign her drug receipt with a Krispy Kreme or Loestril pen. The donut pen is the only one the patients comment on. The patient never touches my black, nondescript, for-my-hands-only pen.

 

[PharmDstudent]

How do you imagine that the commercials work? Why are patients going to their doctors about medications that they don't need?

When you use a drug company's pen, you advertise for them. Keep that in mind.