Having Lunch with the Pharmaceutical Companies

 
Last month, during a break at a ‘Withdrawing from Medication’ workshop we held in Holyoke, someone approached one of us to express disappointment that so few people came to an RLC outreach presentation at the provider agency where that person worked. She explained that lots of clinicians show up at pharmaceutical presentations because they provide expensive lunches that people enjoy. She suggested that perhaps we ought to consider offering another presentation to her organization with lunch included, as well. What did we think?
 
For better or worse, we don’t have the budget to offer lunches with our outreach presentations, and it also would make many of us uncomfortable to start competing with pharmaceutical companies or replicating their methods. In that conversation, it was suggested that another path to address the issue would be for her to propose that her organization stop accepting pharmaceutical lunches. She responded flatly that she didn’t think that was going to happen. That she did not take this suggestion seriously was not her ‘fault,’ but is really quite the norm based on the expectations that have been shaped by what we’ve been told and seen around us, and that really got some of us thinking.
 
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As we learned from presenter David Cohen at that very same presentation, pharmaceutical companies (according to statistics from 2011) spend over $10.5 billion per year on marketing for four classes of psychiatric drugs alone.

10.5 BILLION DOLLARS. At the same time, many psychiatrists acknowledge that much of their information about specific drugs comes from pharmaceutical representatives. These are the same representatives who are paid a large percent of that $10.5 billion to convince people to use their product, NOT to educate and provide unbiased information.

So, do we have a right to say no to these pharmaceutical reps and their gifts of free food and other ‘perks’? Yes, actually we do. Laws vary from state to state, but it’s worth noting that:

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In looking at the Massachusetts database, we found that in 2011, $1,114,025.00 was declared by pharmaceutical companies for gifts of food. This database represents the minimum standard in the state. Pharmaceutical lunches are not illegal and may still be used as a tool, but gifts must be declared. However, there is also nothing to stop us from setting higher standards as individuals and organizations.

It’s hard to be the first individual to suggest change or the first organization to implement a controversial policy, but at least one such organization already exists in our state. Around about 2006, Advocates, Inc. (based in Framingham and providing a variety of traditional services including Community Based Flexible Supports, Emergency Services, clinic services, and so on) made a decision to set their own rules about pharmaceutical gifts. They started by banning non-food gifts (pads, clocks, etc.), and eliminating attendance at pharmaceutically sponsored dinners for medical staff. In the last three years, they took another big step and banned pharmaceutical lunches.
 
Advocates did not come to these decisions lightly or easily, but one representative identified their motivations as follows:
 
This was not an anti-medication issue for Advocates, nor should it be for the rest of us. Instead, it is about creating space for unbiased information and education, and evening the playing field for all of our voices to be heard around choice, self-determination and the many different paths and resources available. And, what does this mean for you?
 
It means you DO have the right to ask the organization that you receive services from, or that you work for, to change their practices around gifts from the pharmaceutical industry.
 
For more information on how Advocates went through their process, see our article here: “Advocates, Inc. – Limiting the Influence of the Pharmaceutical Industry.”