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    September 12, 2006
  
  Stanford to Ban Drug Makers’ Gifts to Doctors, Even Pens   By ANDREW POLLACK
    Stanford University Medical Center will prohibit its physicians from accepting even small gifts like pens and mugs from pharmaceutical sales representatives under a new policy intended to limit industry influence on patient care and doctor education. 
  The new policy, which the medical center is expected to announce today, is part of a small but growing movement among academic medical centers. Yale and the University of Pennsylvania, for instance, have announced similar policies. 
  “We want to secure the public trust to value what happens in academic medicine,” Dr. Philip A. Pizzo, dean of the Stanford School of Medicine, said in an interview. 
  He said the new policy would cost the medical center millions of dollars a year in industry support, like free meals that would now be largely prohibited. “Many faculty members and departments have become dependent on sponsored meals from industry in order to run seminars,” he said. 
  The new policy, which takes effect Oct. 1, would also prohibit doctors from accepting free drug samples and from publishing articles in medical journals that are ghost-written by industry contractors. 
  The policy would also apply to sales representatives from makers of medical devices and other companies, not just pharmaceutical companies. Company representatives would be barred from areas where patient treatment and doctor education occur, with some exceptions. Doctors buying medical equipment would have to report any financial relationships with equipment suppliers and could be excluded from the decision-making, the university said. 
  The move is part of a reaction against corporate influence on medicine at a time of growing concern over the safety and rising cost of drugs and medical devices. About 90 percent of the pharmaceutical industry’s $21 billion marketing budget is directed at physicians, according to an article by an influential group of doctors, scientists and lawyers in The Journal of the American Medical Association in January. 
  That article called upon academic medical centers to adopt policies like Stanford’s, saying that existing guidelines, like a prohibition of expensive gifts, did not go far enough. Some studies have shown that even small gifts create a sense of obligation, they wrote, while free drug samples are “a powerful inducement for physicians and patients to rely on medications that are expensive but not more effective.” 
  One of the article’s authors, Dr. David Blumenthal, a professor at Harvard and director of the institute for health policy at Massachusetts General Hospital, said yesterday, “I’ve been pleasantly surprised at the influence that article had.” 
  Scott Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said the new policies were a “disservice to patients and physicians” because they keep doctors from interacting with sales representatives. “The company sales representatives, in our point of view, have a lot of useful information on drug products and how to use them, and how not to use them,” he said. 
  David Magnus, director of the Stanford Center for Biomedical Ethics, said the new policy contained “just about everything I wanted” and predicted that it would lead to “a pretty major change in our culture.” Dr. Magnus was on the committee that developed the new policy over the course of about a year. 
  The new policy does not cover consulting agreements between faculty members and companies aimed at developing drugs or medical devices. Those are governed by an existing conflict-of-interest policy. 
  Such interactions are especially important at Stanford, where many professors have been involved in starting or advising companies in nearby Silicon Valley. 
  The medical school’s more than 700 faculty members disclosed 299 potential conflicts related to their research last year, The San Jose Mercury News reported in July. More than a third of the school’s administrators, department heads and other leaders had some financial interests related to their research, the newspaper said.
  A Stanford spokeswoman said having a financial interest is not necessarily a conflict if the faculty member is not providing patient care. 


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