Massachusetts Considers New Restrictions on Pharmaceutical Firm Gifts to Doctors

Published September 1, 2008

A legislative panel has stripped from the House version of a Massachusetts bill regulating health care a proposed ban on gifts from pharmaceutical company representatives to doctors.

Analysts commended the legislators’ decision not to impose the new regulation, but they predict Massachusetts’ insistence on maintaining policies that keep the cost of health care high will prevent the move from having much overall effect. The legislation still includes major new restrictions on contacts between doctors and pharmaceutical representatives.

Banning Meals and Gifts

Both the House and Senate versions of the legislation contain similar restrictions under the guise of establishing a marketing code of conduct for the drug industry.

For example, the bills allow pharmaceutical reps to provide meals at physician offices and hospitals, but they ban companies from offering physicians meals at restaurants and giving gifts such as mugs and pens bearing the names of the drug companies.

The Senate bill, SB 1239, sponsored by state Sen. Therese Murray (D-Plymouth), would require drug and medical device companies to report interaction and financial exchanges with doctors to the state’s Department of Public Health, which would be required to post that information on its Web site.

The House of Representatives’ Joint Committee on Health Care Financing stripped the reporting requirement from HB 4974, the House version, as well as a proposal that a failure to comply with the mandate bring a $5,000 fine.

Concerned about Appearances

“The most important implication of the House panel’s decision to strip this ban from their legislation is that it will end the appearance that doctors are taking gifts in return for recommending expensive drugs to their patients, to the benefit of pharmaceutical companies,” said Paul Guppy, research director at the Washington Policy Institute.

Politicians are free to believe such a ban “will help the medical profession maintain high ethical standards,” said Guppy. “It is good that doctors will not be receiving gifts and meals from pharmaceutical companies that are trying to sell their products, but I don’t think doctors receiving these small favors are contributing much to the rising cost of caring for sick patients.”

In addition, Guppy warned, regardless of which version of the bill is finally passed, it “will do very little to rein in health care spending, because it is not directed at the main causes that are driving up costs in the first place.”

Counterproductive Measures

“Pharmaceuticals represent about 10 percent of our nation’s health care spending,” noted Grace-Marie Turner, president of the Galen Institute. “While political leaders focus a disproportionate amount of their attention on reducing costs and spending in this one sector, a good argument can be made that, in actuality, we aren’t spending enough on drugs.”

According to Turner, several studies show increased spending on medicines reduces other health expenditures by treating diseases and chronic conditions so they don’t reach a crisis stage requiring more expensive care and hospitalization.

“Treating diabetes, heart disease, and high blood pressure properly with medications, for example, can avoid amputations, heart attacks, and stroke–procedures and conditions that cost far more than the treatment necessary to simply prevent them in the first place,” Turner explained.

“Massachusetts lawmakers will be disappointed if they think this bill will lower health care costs,” Guppy said. Either bill “may sound good in a press release to their local newspaper, but the real-world effect on rising health care spending will be close to zero.”

Both bills were passed on July 15. A conference committee will attempt to reconcile the differences before a final vote.

Dr. Sanjit Bagchi ([email protected]) writes from India.

For more information …

Senate Bill 1239:

House Bill 4974: