THE NEW YORK TIMES
June 11, 2002
Vt. Takes Aim at Drug Co. Freebies
By THE ASSOCIATED PRESS
New York Times
Filed at 2:11 p.m. ET
MONTPELIER, Vt. (AP) -- Vermont is about to become the first state to take aim
at drug companies' practice of lavishing everything from ball point pens to free
trips on doctors and nurses. Under a law that Gov. Howard Dean, a doctor, plans
to sign on Thursday, any gifts valued at $25 or more, other than free drug
samples, must be reported to the state by pharmaceutical companies.
Critics of the pharmaceutical industry charge that the use of freebies by sales
representatives to promote products drives up medical costs by encouraging
doctors to prescribe new, more expensive brand-name drugs. ``This disclosure
should embarrass this greedy industry into playing fair,'' said state Senate
President Pro Tempore Peter Shumlin, a Democrat. The industry argues that
doctors are not unduly influenced by the freebies and that the law is
unnecessary. The pharmaceutical companies say that they are merely educating
health care professionals about new products, not trying to promote more
expensive drugs over cheaper, equally effective alternatives.
The law is one of a growing number of state initiatives to control the rising
health care costs that are burdening patients and straining state budgets.
``I think they should put more pressure on the drug companies to save money
because the prices are ridiculous,'' said Elizabeth Peterson, 81.
She and her husband must pay $5,566 a year out of their $19,824 income for drugs
to treat such diseases as arthritis and Alzheimer's. Spending on prescription
drugs climbed 17.1 percent in 2001 to $154.5 billion, according to the National
Institute for Health Care Management Research and Educational Foundation. With
action in Congress held up by political infighting, many states have taken the
lead.
Vermont heads a Northeastern coalition that is trying to organize consumers from
Maine to Pennsylvania into a large bargaining group that could negotiate lower
drug prices. West Virginia has led almost two dozen states in a pool that hopes
to win discounts for Medicaid beneficiaries and state employees. Maine passed a
law that uses the threat of price controls to try to negotiate lower drug prices
for the uninsured. But the new Vermont law is the first to go after the
industry’s aggressive marketing to health care professionals.
``This is model legislation that is being recognized and being shared with other
states,'' said Bobbie Kamen, state director of the retirees group AARP, which
lobbied for the law.
Vermont's law also requires pharmaceutical companies to bid competitively to
sell drugs to people enrolled in the state's health care programs; directs the
administration to negotiate for rebates; and authorizes the state to negotiate
prices not just for people on state programs but for those with private or no
pharmaceutical insurance.
The pharmaceutical industry spent $15.7 billion in 2000 on advertising and
marketing, nearly half of that on free drug samples for doctors, according to
Jeff Trewhitt of Pharmaceutical Research and Manufacturers of America, an
industry trade group. Most of the rest of that amount includes other freebies
given to doctors and advertising in medical journals. With health care costs
under attack, the trade group recently adopted a set of voluntary guidelines on
freebies. It says: ``Nothing should be offered or provided in a manner or on
conditions that would interfere with the independence of a health care
professional's prescribing practices.''
Pens, notepads, calendars and other freebies bearing drug names are familiar
sights in doctors' offices. In addition, an April survey by the Kaiser Family
Foundation found that 92 percent of doctors accepted free drug samples, which
then can be given to patients. And 61 percent said they accepted meals, tickets
to entertainment events or free travel from the industry.
``I have a problem with the idea there are a lot of doctors being sent to
Jamaica,'' Republican state Rep. Patricia O'Donnell said. ``I don’t doubt
doctors get free pens and pencils and clocks. That's not going to influence
whether they prescribe.''
But Trewhitt said it is more likely that a sales representative will buy
sandwiches and pizza and make an educational pitch to a doctor’s practice over
lunch.
``That's well within the guidelines,'' he said, ``and you're certainly not going
to buy a doctor's soul for the price of a pizza pie.''
On the Net: Vermont Legislature:
http://www.leg.state.vt.us/
Pharmaceutical Research and Manufacturers of America:
http://www.phrma.org
