On October 11, 2018, Philadelphia Councilman Bill Greenlee introduced legislation to regulate how pharmaceutical representatives can interact with doctors and other health care providers. The legislation, offered in conjunction with Mayor Jim Kenney’s administration and co-sponsored by Councilwoman Cindy Bass, adds a new chapter to the Health Code for the City of Philadelphia.
The bill requires pharmaceutical manufacturers’ representatives to register with the Health Department and display an identification badge whenever they are engaged in sales, marketing, or promotion on behalf of pharmaceutical manufacturers. The sales representatives must also submit all written materials that they are using to promote their drugs to the Health Department for review. This review will enable the Health Department to determine if any further education and training is needed for pharmaceutical agents or health care providers. The Bill also authorizes the Health Department to assess a reasonable annual registration fee not to exceed $250 for each pharmaceutical manufacturing agent registered under this bill to help defray the costs of administering the work set forth in the Chapter.
The bill also prohibits the distribution of gifts to health care providers, their offices, their employees, or staff. This includes everything from travel and lodging costs to food, pens and coffee mugs, in addition to prohibiting the distribution of discount coupons that can be used to purchase opioids.
The legislation does not ban the following: reasonable compensation and expense reimbursement to a health care practitioner who serves as a speaker or on the faculty at a professional or educational conference or meeting; reasonable compensation for the substantial professional or consulting services of a health care practitioner in connection with a genuine research project; providing samples to a practitioner for the sole purpose of distributing the samples to patients with no cost; and funding for Continuing Medical Education (CME) consistent with the standards of the Accreditation Council for Continuing Medical Education (ACCME).
The way the bill is written, it first goes through several “whereas” clauses, citing the impetus behind the bill. Some of the included clauses are: “WHEREAS, the opioid crisis has reached epidemic proportions in Philadelphia, such that over 1,200 people are believed to have died from drug overdoses in 2017, over 80% of which involve prescription opioid painkillers, heroin, or fentanyl; and where tens of thousands of people are believed to be addicted to opioids;” and “WHEREAS, four out of five new heroin users nationally started with prescription opioids;” and “WHEREAS, prohibiting gifts of any value from pharmaceutical representatives to heath care providers will reduce inappropriate influence and restore trust among patients in their providers.”
According to Councilman Greenlee, “We need to attack the opioid crisis from all angles. While this legislation will not solve the problem, it will be one tool in the arsenal to combat this epidemic.”
“While we respond to the current addictive drug crisis, we should also prevent the next one,” said Dr. Thomas Farley, Philadelphia’s Health Commissioner. “Pharmaceutical companies have the right to communicate with doctors and their staff, but they should not be allowed to use gifts like meals to get doctors to hear their sales pitches.”