Ban on gifts to doctors sought in Massachusetts

FROM THE BOSTON GLOBE: Senate President Therese Murray proposed a total ban on all gifts and freebies to doctors from pharmaceutical companies, a move that would make Massachusetts the first state in the country to ban such gifts outright.

The measure is part of a set of healthcare reform measures Murray filed in a bill yesterday that also includes requiring all doctors statewide to adopt electronic medical records by 2015, allowing patients to choose nurse practitioners as primary care providers, and forcing public reviews of any insurance company efforts to boost annual premiums by more than 7 percent.

"There's going to be a climate change, and there has to be a climate change; otherwise our healthcare reform will implode, just under the costs," Murray said at a press conference at the University of Massachusetts Medical School yesterday.

The ban forbids the pharmaceutical industry from giving - and doctors, their families or employees from receiving - gifts from drug companies. Gifts include payments, entertainment, meals, travel, honorariums, subscriptions, even a pen with a drug company logo.

The legislation would continue to permit distribution of drug samples to doctors for the exclusive use of their patients. Anyone who violates the ban could be fined $5,000, face two years imprisonment, or both, under the proposal.

Other states have passed laws attempting to limit the pharmaceutical industry's influence. In Minnesota, legislators enacted a ban on gifts in excess of $50 from pharmaceutical companies. In Vermont, legislators have passed laws requiring pharmaceutical company representatives to disclose the dollar value of gifts over $25 to doctors. Peggy Kerns, director of the ethics center at the National Conference of State Legislatures in Denver, said Murray's legislation is the first attempt at an outright ban on gifts to doctors that she had heard of.

Kerns said that many states are considering or have passed bans on gifts from lobbyists and industries to elected officials. "I think it's legitimate and I'm sure the legislators are doing it for the public good," she said. "I've just never heard of it, and it seems like the place to start would be within their own ranks."

Massachusetts law already prohibits gifts to legislators and other public officials of "anything of substantial value," or anything worth more than $50.

The ban on drug and device company gifts to physicians was first proposed in 2005 by state Senator Mark C. Montigny, a New Bedford Democrat, who said yesterday by phone that he was "very pleased" to see it included in Murray's proposal. Montigny said he grew concerned about the cost of drugs bought through state-sponsored healthcare programs as chairman of the Senate's Healthcare Committee.

He said he was disturbed to see drug companies hire salespeople including "former beauty queens and cheerleaders" who wine and dine doctors and encourage them to prescribe drugs that may not be the most cost-effective.

You would not believe the conflict of interest here," Montigny said. "Of all the nasty manipulation that's gone on, there's no more effective group at getting more than they deserve at the expense of the taxpayer than the pharmaceutical industry." He said the state continues to overpay for drugs.

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Julie Corcoran, deputy vice president of the Pharmaceutical Research and Manufacturers of America, a trade organization based in Washington D.C., said the industry's sales people are "highly educated and trained by their companies." The group opposes any ban, saying the pharmaceutical industry is already heavily regulated by the Food and Drug Administration. "I'm not aware of any kind of evidence or studies that link promotional or marketing materials with the cost of healthcare," she said.

Mike Webb, chairman of the Massachusetts Biotechnology Council, said in a statement issued via e-mail yesterday that he applauded the scope of Murray's healthcare proposal, but was "concerned about any measures, such as bans on interactions with physicians, which could negatively impact information flow to practitioners and ultimately hurt patient care."

The proposed ban is also more strict than the current policy proposed by the American Medical Association. That policy bans cash gifts, but allows doctors to receive textbooks, modest meals, and "other gifts that serve a genuine educational function." The association also allows doctors to receive drug samples for personal or family use.

Money for Murray's proposal to spend $25 million annually to implement electronic health records reform would come from a House-proposed $1 cigarette tax hike. Murray estimated the new tax would produce up to $175 million in new revenue.

Governor Deval Patrick and House Speaker Salvatore DiMasi did not immediately embrace the gift ban or any other specific provisions of her bill. Patrick said he had discussed the plan with Murray and reviewed a bullet-point summary of the bill. He said yesterday: "There's a lot of really good ideas in there, and I look forward to working with her on that." David Guarino, a spokesman for House Speaker Salvatore F. DiMasi, said in an e-mailed statement that DiMasi "wholeheartedly agrees with the principals put forward . . . in the bill and shares concerns about keeping healthcare costs from rising at double-digit rates."

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