Some medical schools say no to drug reps' free lunch

Stanford, Yale and the University of Pennsylvania have adopted policies to create a brighter line between medicine and marketing.

By Myrle Croasdale, AMNews staff. Oct. 9, 2006.

On Oct. 1, Stanford University School of Medicine in California closed its last avenue for pharmaceutical marketing on campus, shutting down drug company freebies no matter what their size.

The ban includes everything from free lunches to pens touting the latest medication to hit the market. Also, pharmaceutical sales representatives must make appointments if they want to talk with physicians. The stricter rules come after the school prohibited drug samples several years ago, except at medical students' free clinics.

Stanford is one of a handful of academic medical centers expanding conflict-of-interest rules beyond research to include smaller gifts aimed at influencing physicians' clinical practices, namely prescribing.

Although there is no hard number on how much is spent, Stanford estimates that drug companies lay out about $250,000 annually on meals there. Nationwide, the pharmaceutical industry estimates that it spends $21 billion a year on marketing, though some contend that this figure is too low.

"There's a growing awareness that pharmaceutical promotions subtly, and not so subtly, impact physicians' decisions," said internist Clarence Braddock, MD, MPH, an associate professor at Stanford and a member of the Stanford Center for Biomedical Ethics. "Even if [you believe] there's not a real impact, the public perception of us cozying up with industry was not something we felt comfortable with."

Proponents of stringent policies see them as a way to build public trust in the medical profession and ensure that the most appropriate drug is prescribed, not the most marketed. They also hope to set an example for the next generation of physicians.