The Ross rep recently told me that the Ross Adult Nutritional products
division recently climbed into bed with the PREMIER BUYING GROUP.  Premier
is a national bulk buying group that many hospitals participate in.
 Premier buys the drugs and hospital products from the manufacture at a
deep discount with the understanding that the products will be the
exclusive drug or product that is available from the discount buying group.
 As an example, over the years our hospital has gone from Tagemet to Zantac
to Pepcid as the preferred IV H2 blocker at our hospital.

Anyway Ross has an agreement with Premier that Ross will discount the Adult
Nutritional Products (The things used for NG and tube feedings like Ensure
and Jevity) if 90% of the infant formula used at the hospital is Similac.
 The Ross rep stressed to me that "this is only for the formula feeders, we
don't want to give formula to BF babies."

The Ross marketing people have really come up with an convoluted way to
keep the free formula in the hospital by tying it's use to the use of the
adult products.  What this agreement means is that if our hospital chooses
to use the brand name Enfamil for 50% of the formula used at the hospital,
then the hospital would not be able to get the "Adult formulas" at the
discount price.
Technically this wouldn't prevent complacence with the BFHI if the infant
formula was purchased, but of course that doesn't happen except in rare
cases.

Jon Ahrendsen MD FAAFP
Clarion, IA