On January 1, 2009, the Pharmaceutical Research and Manufacturers of America1 enacted a new code governing the interactions between pharmaceutical company representatives and health care professionals. The new code, while voluntary for the pharmaceutical manufacturers and physicians, has been endorsed by more than 30 major companies, and it will eliminate small gifts to physicians such as the familiar logo-embossed pens and coffee mugs. The new code, however, does not prohibit sponsorship of office-based or hospital-based meals, continuing medical education (CME) events, or other forms of marketing contacts that are also exceedingly common. Blumenthal2 noted in 2004 that over 90% of physicians in the United States reported at least 1 yearly interaction with a pharmaceutical company, typically in the course of an office “detailing” visit or a CME event. Wazana3 reported in 2000 that, on average, practicing physicians met with drug company representatives 4 times a month. Thus, elimination of small gifts alone will not reduce the contact of physicians with pharmaceutical representatives, and the question remains as to whether the new code of interactions is enough to assure that physicians act in the best interest of their patients at all times, uninfluenced by biased information from drug company marketers.
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