Regardless of how much I may agree with the general objectives of a professional organization, there are times when I just have to question the effectiveness of its tactics. Last week, the Pharmaceutical Research and Manufacturers of America revised its PhRMA Code on Interactions with Healthcare Professionals. The document is an updated list of the original 2002 edition describing what constitutes as the “highest ethical standards” for pharmaceutical marketing professionals when communicating with healthcare providers.
Compliance with the code is voluntary, and PhRMA says it will post a list of those companies who have pledged to follow the code on its website. In addition, a company’s own “compliance officer” and CEO are tasked to annually certify that the company is actually in compliance.
Few can argue with PhRMA Chairman Richard Clark’s statement that “informative, ethical, and professional relationships between healthcare providers and America’s pharmaceutical research companies are instrumental to effective patient care.” However, I can’t help but wonder, Are patients really the ones who are benefiting from this program?
The Biotechnology Industry Association supports of the code, with President and CEO Jim Greenwood stating the “adherence to strict ethical standards and compliance with applicable laws is critical … to maintain the trust of patients.” No arguements, here. Consumer trust is good for the industry. I understand how Sarbanes-Oxley, upon which this code is modeled, has changed the ethics policies of many industries. However, aside from the good principles on which it is based, is this particular ethics code, directed specifically for product marketing between the company and the healthcare professional, really necessary or is it just a documentation of what should already be standard good business practices, integrity, and common sense?
Under the revised code, sales reps, for example, are not allowed to distribute to healthcare professionals any noneducational promotional material (say goodbye to pens and notepads), and they are required to be up-to-date on applicable laws and regulations (aren’t they already?). Here’s another change: The 2002 version of the code allowed marketing reps to take healthcare professionals out to “lunch or dinner at a quiet restaurant.” Well, no more. Starting in 2009, restaurant meals are forbidden, although sales reps can still provide “occasional meals” in the healthcare professional’s office (as long as it’s accompanied by an “informational presentation”). I’m failing to see how this particular change ties into the goal of “serving patients’ needs.”
Will the code have any effect on consumer trust? Has consumer and patient confidence in the industry increased since the original code went into effect in 2002? Speaking just from a personal perspective: of the medications my family has been prescribed since 2002, at least one has been recalled and two others have been investigated for “serious adverse events” that were not known until post-launch. Knowing whether my family physician did or did not receive a coffee mug from those companies would not have influenced my trust in the industry at the time.
In fact, despite efforts, consumer trust remains a major concern in the industry. According to a 2006 PricewaterhouseCoopers report Recapturing the Vision: Restoring trust in the pharmaceutical industry by translating expectations into actions, four years after the original code, “a few pharmaceutical companies maintain position among the world’s most reputable companies.” In addition, one of the findings of the survey-based report is “Stakeholder groups and consumers continue to have concerns about the nature and extent of pharmaceutical sales and marketing practices.”
Marketing ethics, as part of overall industry integrity, is a decent start to a foundation toward building trust in the industry. Whether it will actually provide more benefit to patients or the company itself is debatable.