Pens, Pizza, and Prescriptions: A New Era in Drug “Gifting”?

You’re waiting in the lobby of the doctor’s office with a brutal sore throat. In between painful sips of water that the office assistant kindly provided, you notice something strange: a sharply dressed person entering the office with what appears to be several grocery bags.

The cold medicine might be making you a bit dreary, but you’re not seeing things. In fact, you’ve just witnessed something patients see in waiting rooms across the country, one that helps to characterize the landscape of American healthcare: a gift-bearing drug company representative.

For years, drug reps have been showering physicians with pens, clocks, notepads, and a host of other gifts — including free meals and, in some cases, trips — to help market their products. However, recent legislation signed into law by Masssachusetts Governor Deval Patrick places limits on the types of gifts drug companies may provide health professionals. The new law requires companies to publicly disclose any gift worth more than $50 and bans high-end gifts such as sports tickets and free travel.

Massachusetts isn’t alone, however. Vermont and Minnesota already have state laws requiring the reporting of drug company payments to doctors.

The Massachusetts law comes on the heels of an industry-wide code of conduct adopted in July by PhRMA, set to take effect in January 2009. The code places a ban on “freebies” such as pens, mugs, and notepads. However, small meals — like free pizza during informational sessions — are still allowed.

Drug companies and biotech groups aren’t happy with the new legislation. John Hefferman, vice president of the Massachusetts Biotechnology Council, told Gov. Patrick that the law “could erode the state’s competitive edge…and has already created negative buzz in the life sciences industry.”

But do pens and notepads really make doctors prescribe certain drugs more often than others? Gwen Ifill tried to get to the heart of that question during a 2006 debate on the NewsHour with Jim Lehrer. As Dr. David Blumenthal asked during the debate, would drug companies spend money on freebies if they got no return?

The answer, according to The Prescription Project, is “no.” The organization recently published a report titled Why Small Gifts Matter, which found that industry interactions with drug studies led to increased prescription drug costs.

Maybe those grocery bags filled with pens, clocks, and notepads have an impact after all. It’s certainly an interesting ethical debate that raises conflict-of-interest questions. But whether or not more states join Massachusetts, Vermont, and Minnesota in reporting drug gifts, those pens and notepads may be history next year.