VPIRG opposes S.45

This session, the Vermont Senate passed a bill that would have weakened the state’s existing strong law banning gifts from pharmaceutical and medical device companies to Vermont medical professionals.

More and more, researchers are finding that gifts – even as seemingly insignificant as a free meal – have a real impact on consequent decisions made by the gift-receivers. Vermont’s “gift ban” law, passed in 2009, has successfully dropped the rate of medical providers accepting industry gifts from about 50% to 20%. In fact, Vermont’s rate of 20% is the lowest in the country!

Unfortunately, industry groups in some circumstances have retaliated by making it more difficult for doctors and other providers to attend sponsored events. While we believe that this is a problem that needs to be addressed, the solution should not come at the expense of existing and successful patient protections.

S.45, which aimed to roll back some of those protections, is currently in the House Health Care Committee. Fortunately, it is not expected to continue forward this session.

Read our letter to the House Committee on Health Care, below:


I am writing to express VPIRG’s opposition to S.45, because it’s our belief that this bill would weaken consumer protections already in place against the undue influence of drug makers and medical device manufacturers.

At a time when public confidence in some of our most important institutions is waning, health costs are skyrocketing, and the influence of drug companies continues to swell, Vermont should not step back from the strong stand taken years ago to alleviate conflicts of interest between medical professionals and the pharmaceutical and device industries.

In 2009, VPIRG supported the passage of Vermont’s ban on industry gifts to medical professionals, and the law has been quite effective to date. Between 2007 and 2008, drug manufacturers reported spending almost $3 million in Vermont, with payments going to nearly 50% of Vermont’s licensed health professionals.[1] Five years after the implementation of Act 59, data collected by ProPublica shows that just 20% of Vermont’s hospital-affiliated doctors accepted payments or meals – the lowest in the country.[2] These numbers show that Vermont’s law has been largely successful in achieving its goal – so why roll back progress?

Vermont’s achievement is particularly important given the number of recent scientific studies that show that even a free meal from pharmaceutical and medical device companies can result in undue influence.[3],[4],[5]  In the vast majority of cases, it is not a matter of greedy or credulous doctors, but simply basic psychology that shows that those who receive gifts (including meals) feel obliged to the gift-giver.

A 2016 paper published in the Journal of the American Medical Association (JAMA) Internal Medicine found “Receipt of industry-sponsored meals was associated with an increased rate of prescribing the brand-name medication that was being promoted.”[6] In fact, “higher rates of prescribing were also observed when doctors received just a single meal, even after taking into account a physician’s specialty and region of practice.”[7]

We are aware that certain drug companies are taking what might be considered a punitive approach toward medical professionals from Vermont. We encourage the Committee to explore reasonable options to prohibit such conduct wherever possible. Our doctors should not be prevented from attending educational forums just because “free” lunches are provided by drug or device manufacturers. Instead, there should be an easy means for professionals from Vermont (or other states that take similar action to protect against conflict of interest) to pay for their meals.

Regardless of whether you take any additional steps to prevent punitive actions against Vermont’s medical professionals attending educational forums, we urge you to reject any rollback of existing protections contained in Vermont law, including specifically the rollback contained in S.45. Please defend patients’ best interests and adhere to the compelling research that tells us that Vermont was right to pass Act 59 back in 2009.

 

[1] http://www.leg.state.vt.us/docs/2010/acts/act059.pdf
[2] https://projects.propublica.org/graphics/d4d-hospital-lookup
[3] https://static.propublica.org/projects/d4d/20160317-matching-industry-payments.pdf?22
[4] http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2528290
[5] https://www.ncbi.nlm.nih.gov/books/NBK22926/
[6] http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2528290
[7] http://www.npr.org/sections/health-shots/2016/06/21/482922838/even-a-small-meal-for-a-doctor-can-tip-the-balance-for-a-brand-name-drug

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