House to offer bill for registry of drug firm gifts to doctors

Pharmaceutical companies would have to report gifts of $25 or more.

By Dave Hansen — Posted Nov. 26, 2007

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A U.S. House lawmaker plans to introduce legislation to create a registry in which pharmaceutical manufacturers would have to report any gifts that are given to physicians.

The measure by Rep. Peter DeFazio (D, Ore.) would be similar to legislation that already was offered in the Senate. But the House bill might apply to companies with less than $100 million in revenues, the threshold set by the Senate bill, said Ed Hill, a legislative assistant for DeFazio. The House and Senate bills would require manufacturers to list both gifts of $25 or more and the physicians who received them.

Between five and eight Democrats have agreed to co-sponsor the House measure, Hill said, adding that DeFazio hopes to get some Republicans to join them. A House vote by the end of 2007 is probably too optimistic, Hill said, but the lawmaker plans to promote the legislation next year.

The American Medical Association has not taken a position on the legislation. But the AMA's ethical guidelines prohibit doctors from accepting gifts of substantial value or any gifts with conditions attached. Gifts also must primarily benefit patients or be related to a physician's work.

Groups rally in support

Anticipating the House introduction, several groups held a Nov. 8 briefing in Washington, D.C., to show support for a national registry.

The bill is necessary because it would publicize potential conflicts of interest between the pharmaceutical industry and physicians, explained American Medical Student Assn. Director of Student Programming Paige Hatcher, who attends the University of Kansas.

Hatcher, who declines all gifts from manufacturers, said she has been offered food, notepads, pens -- "you name it" -- from drug firms even though she is still a medical student. She is critical of a pharmaceutical firm that pays the bar tab for meetings of a group of Kansas medical students interested in psychiatry, even though a company representative does not attend. She pays her own tab.

There is no reason to keep gifts from drugmakers to doctors hidden from the public, said Allan Coukell, director of policy and strategic communications for the Prescription Project, an organization funded by the Pew Charitable Trust that aims to eliminate conflicts of interest between physicians and the pharmaceutical industry.

"There is a great deal of distrust of the medical profession because of its relationship with the pharmaceutical industry, and I think clarity of those relationships is one step toward rebuilding that trust," he said.

Coukell emphasized that the legislation would not penalize physicians nor limit gifts. It only would make the information public, he explained.

Pharmaceutical Research and Manufacturers of America, a drug company trade organization, has not taken a position on the Senate bill, said PhRMA Senior Vice President Ken Johnson. The organization is working with Congress and all stakeholders to ensure that discussions between pharmaceutical sales representatives and physicians are honest and ethical, he said.

PhRMA's voluntary Code on Interactions with Healthcare Professionals regulates activities between companies and doctors, Johnson said. The code says gifts in the form of entertainment are inappropriate and that only modest meals should be allowed at educational presentations.

The Senate bill, introduced by Sen. Charles Grassley (R, Iowa) on Sept. 6, would exempt drug samples and funding for clinical trials.

Drug manufacturers failing to comply with the legislation, called the Physician Payment Sunshine Act, would face fines of up to $100,000 per violation.

The Senate bill would not penalize physicians or require any of them to put their names on the registry.

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