Governor Paterson of New York announced he is introducing a ban on gifts to physicians. Though the bill is not available couple of key points:
A) Ban gifts and payments from drug companies to physicians and other prescribers in excess of $50 per year
B) Require practitioners who make presentations at Continuing Medical Education (CME) events to disclose any financial relationship they have with drug companies
C) Require pharmacy benefit managers (PBMs) to disclose information to health plans, doctors and patients.
a. the actual utilization of drugs by the health plan’s participants;
b. every policy or practice of the PBM that presents an actual or potential conflict of interest with the health plan;
c. Any increase in the net price to the health plan for a covered drug and the reason for the increase;
d. all contracts and agreements entered into by the PBM with a network pharmacy and with any pharmaceutical manufacturer. To prevent PBMs from switching patients to more expensive drugs without the patient’s knowledge and without providing adequate information to the practitioner, the bill requires notification to patients and the provision of relevant clinical and financial information to prescribers before drug switches can be made.
This bill was endorsed by the New York, AARP, Consumer Union, Business and Labor Coalition, and Citizen action. It is worth noting that the bill is designed to fix problems already addressed: For CME disclosure it is a ACCME requirement to disclose your relationships. From our expierence it is working, doctors take disclosure very seriously.
For PBM’s, I don’t know of a single instance where pharmacists are switching patients to brand drugs without their knowlege, but stories every day of un notified switches to gernerics. This morning, I recieved an email, outlining how it was almost impossible to get a brand drug, the pharmacist kept switching all his prescriptions to generics. Even when the doctor writes medically necessary on the prescription, often the pharmacy will not have the branded drug in stock, so they will fill with generic.
The ban on gifts is also suspect in that the definition for gifts almost always includes services and consulting.
If you want to read more here is the Reuters Article
So here we go again…..