Heads up pharmaceutical marketing firms: your branded “freebies” at US medical schools may be on their way out. An editorial in the current issue of Archives of Internal Medicine is calling for the new policies on interactions between pharma companies and physicians, even would-be medical professionals. The editorial highlights a study in that publication investigating whether medical students’ attitudes may be influenced by exposure to small branded items such as pens, clipboards, notepads, etc. That study involved 352 third and fourth-year students from the University of Pennsylvania School of Medicine, which has a strict policy against promotional material, and the University of Miami Miller School of Medicine, which does not.

The research involved assessing the relative attitudes toward Lipitor (Pfizer), the branded promotional product, and Zocor (simvastatin, Merck). Results showed that fourth-year students at the University of Miami Miller School of Medicine exposed to Lipitor promotional items had a more favorable implicit attitudes about that drug. Students at the University of Pennsylvania School of Medicine had a more negative attitude about the promoted product, which researchers say may be attributed in part to the school’s policy. As they observe, “The policy … may have heightened the ability of the Penn students to exercise what has been termed ‘persuasion coping effectiveness,’ which produces a goal within oneself to achieve one’s own current learning or attitudinal goal independently of what the marketer seems to be trying to accomplish.” (There was not a significant difference with third-year students, which researchers attribute to the fact that fourth-year students have more clinical experience.)

Researchers concluded that even small branded items of low economic value may influence a medical professional’s attitude toward a particular drug product. (The study did not evaluate the students’ actions, only their implicit attitude of the product).

Efforts to eliminate pharmaceutical promotional material in medical schools would add to existing cutbacks in drug marketing to physicians as well as consumers.

In January, the Pharmaceutical Researchers and Manufacturers of America (PhRMA) enacted a voluntary ban on promotional materials to physicians, and The Physician Payment Sunshine Act requires full disclosure of drug company payments to medical researchers (see related blog post).

Industry-wide drug manufacturers cut prescription-drug advertising to consumers by 8% last year, (from $4.8 billion in 2007 to $4.4 billion in 2008), according to one report. Congressional scrutiny of drug marketing, fewer product launches, and pressures to decrease healthcare costs have led drug makers to scale-back consumer ads.

Meanwhile legislators in Vermont are set to pass a bill that would ban or place strict controls on the gifts, samples, meals, etc. that drug companies provide to doctors. The arguments focused on, for example, whether companies should ban the practice of providing lunch during a presentation or whether these companies should disclose for public review the names of the doctors that received the lunch. According to an April 2009 report, 78 pharmaceutical manufacturers spend $2.9 million to market and provide education about their products to Vermont doctors, hospitals, and university researchers in one year. During the discussions before the state’s House Health and Welfare Committee, PhRMA representative Marjorie Powell said that “It’s easier to get everyone together if a pharmacy rep can bring in sandwiches and talk about a medication.” However, Susan Baker, healthcare advocate with the Vermont Public Interest Research Group, argued that “the medical profession isn’t low income. They can afford their own food.”