Sign on to our letter!

    Please add your voice to those of providers around the Commonwealth in calling for ethical industry interaction standards. In the next two weeks our broad coalition will deliver this letter to key officials at the MA Department of Public Health, Executive Office of Health and Human Services, Governor’s Office, and the Public Health Council members. We need your signature to show that we, as providers from the Commonwealth and across the country, are disappointed in these weakened regulations and expect higher ethical standards in our profession.



    To the Department of Public Health:

    As physicians, resident physicians, medical students, and allied health professionals in the Commonwealth and across the country, we write to express strong concern over the Department of Public Health’s emergency regulations on the Pharmaceutical and Medical Device Gift Ban and Disclosure Law (105 CMR 970.000). We urge DPH to amend the current emergency regulations to protect the well-being of our patients and to uphold ethical standards of our profession.

    The DPH’s emergency regulations fail to create clear limits on how much pharmaceutical and medical device companies can spend on food and refreshments while promoting treatments to prescribers. The unfortunate fact is that every dollar spent on marketing makes health care more expensive for Massachusetts residents. One in five Americans already skimp on groceries just to fill their prescriptions. We call on you to create a clear definition of “modest” in your regulations to ensure that no Bay Stater has to choose between medications and putting dinner on the table.

    The current regulations also contradict ethical norms of the medical profession, which acknowledge that gifts and meals skew prescribing decisions towards more expensive treatments—even when there is no evidence that they provide a medical benefit. The most preeminent institutions of our profession, including the Institute of Medicine and the Association of American Medical Colleges, have called for an outright ban on industry gifts and meals. In Massachusetts, every single medical school prohibits faculty from receiving industry-funded meals on campus. Perhaps most tellingly, PhRMA itself bans industry-funded meals for physicians in restaurants within its voluntary code of ethics, citing fear that education will not be the primary focus of a restaurant meal.

    We therefore call for the following changes to DPH regulations on allowable meals and refreshments:

    • Define “modest” with a clear monetary limit.
      The emergency regulations define “modest” meals as “what a health care practitioner might purchase when dining at his or her own expense.” While we believe that no industry funding of meals should be permitted, within the current legislative context, the DPH definition of “modest” is inappropriately vague and unenforceable. We call for the DPH to institute a clear monetary limit on allowable meals, such as those that exist for state and federal employees on work-related meals.
    • Ban alcohol at industry-funded events and presentations.
      Providing doctors alcohol is inappropriate when medical information is being exchanged. Scientific studies support the common sense intuition that alcohol impairs the capacities to learn and to make effective decisions, an unacceptable risk when information presented can impact the health of many patients.
    • Collect adequate information on how money is spent on newly allowable meals.
      The DPH must understand the impact of newly allowable meals on our profession and our patients. DPH regulations should include provisions that collect and make public information on the location of presentations, a description of products promoted, and estimates of total and per-capita expenditures at each event, as required by statute. Much of this information is not required by federal law in the Physician Payment Sunshine Act, and is important information for our patients to understand.


    The true “emergency” that we must confront is that seven in ten Americans believe that their doctors’ decisions are “too influenced” by pharmaceutical companies. Lack of trust erodes the impact a provider can have on the health of our patients. Please act to protect the trust at the heart of our relationships with our patients. We urge you to amend the current DPH regulations to include all of the above changes.

    Sincerely,
    The Undersigned




    This organizing effort is spearheaded by members of the American Medical Student Association and the National Physicians Alliance.
    Please contact us with any comments, questions, or concerns!
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