Minnesota health system purges drug trinkets

By STEVE KARNOWSKI, Associated Press WriterSat Jan 19, 6:42 AM ET

When a Duluth-based operator of hospitals and clinics purged the pens, notepads, coffee mugs and other promotional trinkets drug companies had given its doctors over the years, it took 20 shopping carts to haul the loot away.

The operator, SMDC Health System, intends to ship the 18,718 items to the west African nation of Cameroon.

The purge underscored SMDC's decision to join the growing movement to ban gifts to doctors from drug companies.

SMDC scoured its four hospitals and 17 clinics across northeastern Minnesota and northwestern Wisconsin for clipboards, clocks, mouse pads, stuffed animals and other items decorated with logos for such drugs as Nexium, Vytorin and Lipitor.

Trinkets, free samples, free food and drinks, free trips and other gifts have pervaded the medical profession, but observers say that's starting to change.

"We just decided for a lot of reasons we didn't want to do that any longer," Dr. Kenneth Irons, chief of community clinics for SMDC, said Friday.

So SMDC put together a comprehensive conflict-of-interest policy that, among other things, limits access to its clinics by drug company representatives. Employees suggested the "Clean Sweep" trinket roundup, Irons said.

Ken Johnson, a spokesman for the Pharmaceutical Research and Manufacturers of America, had heard of hospitals and clinics banning promotional items before, but said SDMC's purge was unprecedented.

"I've never seen nor heard of a systematic roundup of pens and coffee mugs before," Johnson said. "It's a bit draconian. But the onus is on us now to do a better job of explaining the job and the importance of marketing representatives. Unfortunately there are a lot of cynics in America who want to think the worst."

SDMC's effort was motivated by a desire to show patients that its 450 doctors were serious about keeping prescription drug costs down and making unbiased medical decisions, Irons said.

The backlash against the cozy relationships between doctors and drug makers gained steam from article in the Journal of the American Medical Association in 2006. It said research had shown that even cheap gifts, such as pens, can affect doctors' prescribing decisions.

The Prescription Project, funded by the Pew Charitable Trusts, was founded to promote the JAMA article's recommendations for countering aggressive marketing to physicians by the pharmaceutical and medical device industries.

Marcia Hams, assistant director of the project, said she too hadn't heard of a roundup like SDMC's, but hopes other health organizations follow its lead.

"This seems like a pretty aggressive way to kick off a policy like that," she said. "It sends an important message, I think, for how a strict policy can be implemented in an effective way."

Kaiser Permanente, the country's largest HMO, Veterans Affairs hospitals and medical centers at several universities have recently adopted strict conflict-of-interest policies, such as gift bans, Hams said.

Many of SMDC's items will be going to the health system of the Evangelical Lutheran Church of Cameroon, which has three hospitals, and several rural health centers.

Irons said there shouldn't be a conflict of interest in Cameroon because the advertised drugs aren't available there.

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On the Net:

SMDC Health System: http://www.smdc.org

The Prescription Project: http://www.prescriptionproject.org

Pharmaceutical Research and Manufacturers of America: http://www.phrma.org

About time someone did something good with all the crap that drug reps use to talk physicians into the latest and greatest drug they are peddling.

Drug Rep

Drug rep came to town today peddling his drug with the words, "This drug does not have ANY drug interactions."  "None?"  I said in disbelief processing the information.

He shook his head and smiled while getting my name to write down for the luncheon he was giving.

"NO drug interactions?"  I just can't hardly believe in a statement like that.

"No drug interactions and only about 50% protein bound."

Wow.  First thing I did was go research the drug.  Oh yeah.  It interacts with metoprolol for one.  Raises the AUC of metoprolol by 50%.  Maybe he got his 50% data memorized wrong.  Here's the list Mr. Drug Rep: 

Aspirin

Carbamazepine

Cimetidine

Desipramine

Drugs that act on the brain, including antidepressants, painkillers, sedatives, and tranquilizers

Ketoconazole

Linezolid

Lithium

Metoprolol

Narcotic painkillers

Nonsteroidal anti-inflammatory drugs such as ibuprofen

Sumatriptan

Warfarin

Never say "My drug has no drug interactions."  That's just not gonna fly.

The Angry Pharmacist hates drug reps

Let's go back in time a bit.  I'm married to a great guy (cat's out of the bag, eh?) who went to college with a guy who majored in, oh, let's say, geology.  He was a wild ass in college, partied his ass off, and today is a bonafide drug rep for Eli Lilly.  Not only that, I get the wonderful pleasure of being in his presence of hearing how great Strattera and Cymbalta are.  On and on...  "Hey, Blonde, have you tried Strattera?  It works really well."  He offers to give me samples.  Illegal.  He then attemps at the pharmacology of the drug.  It's obvious it's biased and exactly what EL told him to say.  I chuckle.  I don't have the time to even clarify or clear things up for him.  I don't have to tell him what an idiot he really is and to stop pretending to be a pseudo physician. He puts on a different hat at times with being in charge with the men's group at his church and becomes super preacher as well.

It all reminds me of the kid that has to really overcompensate for low self-esteem.

I just flew by The Angry Pharmacist's first post on drug reps.  Man, he cracks me up and is dead on.  The second post is even funnier as the angry drug reps tried hard to counter yet TAP (The Angry Pharmacist) used all the comments as great fodder for even more.  Love it.