Med Schools Curb Drug-Reps' Free Lunches

At the University of Virginia Medical Center, neurologist Dr. Madaline Harrison chairs a committee of physicians and other hospital employees formally reviewing ethics policies and developing regulations that will address a range of issues, including the drug-rep relationships Jan. 17, 2007 in Charlottesville, Va. (AP Photo/Andrew Shurtleff) (Andrew Shurtleff - AP)

RICHMOND, Va. -- A growing number of U.S. medical schools and hospitals are realizing that there's some truth to the saying "There's no such thing as a free lunch" and are banning drug salespeople from providing meals and other gifts to doctors, medical students and residents.

The move comes in response to concerns about whether the pharmaceutical industry's expensive marketing efforts influence which drugs doctors prescribe and whether those costs get passed on to patients.

"It's about maintaining the right balance, having a constructive relationship with (pharmaceutical) companies and maintaining independence," said Dr. Madaline Harrison, a neurologist who chairs a committee reviewing ethics policies at the University of Virginia Medical Center. The committee is drafting regulations on a range of issues, including the free lunches.

A number of academic medical centers already have tightened their drug-rep guidelines in recent years, including Yale and Stanford and the universities of Michigan and Pennsylvania.

When pharmaceutical reps visit doctors, they hand out items such as pens and notepads imprinted with the name of their drug to increase their product's visibility in a competitive selling environment. They also provide lunches or sponsor medical-education conferences to build relationships with physicians, the gateway between the drug and the patients.

A study published in the Journal of the American Medical Association last year found that third-year medical students get one gift or attend one event per week sponsored by the pharmaceutical industry, which spends $12 billion to $18 billion annually on marketing to doctors and medical residents.

Justin Sanders, national coordinator for the American Medical Student Association's PharmFree campaign, praised the universities that have scrutinized their policies to make sure prescribing habits aren't unduly swayed by drug reps, at the expense of patient care.

"The pharmaceutical industry spends billions of dollars a year to influence us," said Sanders, a medical student at the University of Vermont. "How can a pen make a difference? But it's hundreds of thousands of pens, tens of thousands of lunches."

The practices create a sense of entitlement among doctors, which pharmaceutical companies engender because it's good for business, he said.

"Sales is a relationship. Then when the resident gets out into the field, that's what the pharmaceutical rep is trying to breed," Sanders said. "It only takes one lunch to make a medical student feel entitled. You see it all the time in medical school, and it's amazing."

The Yale Medical Group last year banned all gifts to physicians, regardless of whether it's a pen, notepad or meal. Industry-provided meals are banned from the medical school campus.

Among private hospitals, the Detroit-based Henry Ford Health System has banned gifts and perks from medical salespeople. The policy, which took effect Jan. 1, also requires pharmaceutical and medical-equipment reps to make appointments before visiting physicians, instead of showing up unannounced.