State Licensing drug reps could regulate sales policies

A proposal passed the Massachusetts Senate requiring drug company sales
representatives to be licensed. The Boston Globe reports (below) that the
bill "would require pharmaceutical representatives to complete training
before receiving their licenses and to participate in continuing education.
And it would prohibit them from providing entertainment, gifts, payments, or
travel to doctors, healthcare facilities, or public officials."

The bill’s sponsor, Senator Mark Montigny, said drug company representatives
are subject to less scrutiny than many other professionals who have less
potential impact on people’s health.

“Hairdressers and manicurists must be licensed to work in the
Commonwealth," he said. “Pharmaceutical representatives who market
prescription drugs and attempt to influence doctors to prescribe name-brand
drugs should also be licensed."  

Predictably, industry’s trade group, PhRMA objects to requirements that
would bring drug industry sales reps into a modicum of professionalism. In a
statement, PhRMA senior vice president Ken Johnson said Montigny’s proposal
“would impose an additional burden on the sharing of new information with
physicians."

Dr. Marcia Angell, whose most recent article in The New York Review of Books
("Your Dangerous Drugstore") reviews the misconduct of Merck whose marketing
of Vioxx led to tens of thousands of heart attacks
http://www.nybooks.com/articles/19055 , acknowledged to The Boston Globe an
illicit relationship between the drug industry and doctors:

“There are bribers and bribees. We need doctors to stop taking bribes."

 
Contact: Vera Hassner Sharav
212-595-8974
veracare@ahrp.org <mailto:veracare@ahrp.org>  
 
 

http://www.boston.com/business/globe/articles/2006/06/01/senate_oks_licensin
g_of_drug_reps/
BOSTON GLOBE

Senate OK’s licensing of drug reps
State could be 1st to regulate sales policies

By Jeffrey Krasner, Globe Staff | June 1, 2006

A proposal passed by the state Senate could make Massachusetts the first
state in the nation to license drug company sales representatives and would
prohibit them from providing entertainment, gifts, payments, or travel to
doctors, healthcare facilities, or public officials.

The proposal by Senator Mark Montigny, Democrat of New Bedford, was passed
as an amendment to the state budget. For it to become law, the House of
Representatives must agree to the provisions when after a House-Senate
conference committee offers a compromise budget plan.

Montigny said drug company representatives are subject to less scrutiny than
many other professionals who have less potential impact on people’s health.

“Hairdressers and manicurists must be licensed to work in the
Commonwealth," he said. “Pharmaceutical representatives who market
prescription drugs and attempt to influence doctors to prescribe name-brand
drugs should also be licensed."

The ban on entertainment, gifts, payments, and travel could disrupt the
activities of sales representatives, who often favor discussing their
companies’ products in social settings.

Drug makers also frequently give doctors payments for attending
“educational" events, and offer them and their staff members pens, paper
pads, refrigerator magnets, and other trinkets.

A spokeswoman for the Pharmaceutical Research and Manufacturers of America,
or PhRMA, a trade group for large drug companies, said she is unaware of any
other states that license drug sales representatives.

In a statement, PhRMA senior vice president Ken Johnson said Montigny’s
proposal “would impose an additional burden on the sharing of new
information with physicians."

“The amendment also seeks to impose criminal penalties on what should be
viewed as the important sharing of information between pharmaceutical
companies and physicians regarding the risks and benefits of medicine," he
said.

But Dr. Joseph Gerstein , a whistle-blower in the federal government’s case
against TAP Pharmaceutical Products for improper marketing practices, said
the sales representatives are not engaged in educational efforts.

“If pharmaceutical companies were really interested in education, as
opposed to sales, then pharmaceutical salespeople would be rewarded
according to how accurately and effectively they conveyed the crucial
information about indications, side effects, and toxicity to physicians,"
Gerstein said. “They are not. They are rewarded on how much they increase
sales. That says it all."

A government investigation based in part on Gerstein’s allegations led
Abbott Laboratories and Takeda Chemical Industries to pay $875 million to
settle civil and criminal charges.

Still, some think the measures Montigny seeks are extreme.

“This doesn’t distinguish between what we think are reasonable and
beneficial gifts and inducements that are appropriate for the drug companies
to hand out, particularly if it will benefit the patient," said Dr. Kenneth
Peelle, a radiologist and president of the Massachusetts Medical Society, a
professional group for doctors. “At educational seminars, they’re obviously
pushing their own drug, but they’re also giving useful information."

Drug companies often host dinners with doctors at venues such as Fugakyu
Japanese Cuisine in Brookline and the Four Seasons Hotel in Boston.

Peelle said such events would be acceptable if drug companies provided a
“modest meal," such as sandwiches, in a hospital conference room.

Dr. Marcia Angell , former editor of the New England Journal of Medicine and
a vocal critic of drug industry marketing practices, said she doubted
whether licensing sales representatives was appropriate.

“Licensing somehow suggests that these people are legitimate educators of
doctors," she said. “I suppose it’s better than nothing."

Angell also blamed her own profession for some of the problems related to
improper drug marketing. “There are bribers and bribees. We need doctors to
stop taking bribes," she said.

The Senate measure would require pharmaceutical representatives to complete
training before receiving their licenses and to participate in continuing
education. Thomas Finneran , chief executive of the Massachusetts
Biotechnology Council, said that measure would stifle the biotech industry.

“This is an attempt to smother the industry with another layer of
bureaucracy and regulation," said Finneran. “It’s an oblique attack dressed
up in public-interest clothing."

If the measure becomes law, licensing fees would be split between the
attorney general’s office, where they would be used to prosecute Medicaid
fraud, and the Board of Registration in Pharmacy, where the money would be
used to reduce medical errors.

Montigny said he has separately introduced the proposal as a bill in the
Senate, should the measure fail during the budget talks.

“I’m not going away on this issue," he said. “We need to ban all
manipulation of drug-prescribing practices."

Jeffrey Krasner can be reached at krasner@globe.com.
C Copyright 2006 Globe Newspaper Company

 
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