We previously posted about the legislation Philadelphia City Councilman Bill Greenlee introduced that would ban gifts from pharmaceutical manufacturers to doctors. As a reminder, the bill requires pharmaceutical manufacturers’ representatives register with the Health Department and display an identification badge when they engage in sales, marketing, or promotion of any kind on behalf of pharmaceutical manufacturers.
All written materials used to promote drugs must be submitted to the Health Department for review. The Health Department will then use the written materials to determine if further education or training is needed for pharmaceutical agents or healthcare providers.
The bill also prohibits the provision of gifts to healthcare providers, their offices, and their staff. All gifts are prohibited, including travel and lodging costs, food, pens, and coffee mugs. It also prohibits distributing discount coupons to purchase “addictive drugs.”
Recently, the Health Committee for the City of Philadelphia favorably recommended an amended measure that bans gifts and requires licenses for pharmaceutical representatives. In addition, the City Council has had the first reading of the bill, so it now moves to second reading then final vote.
The amended bill exempted required registration for pharmaceutical representatives whose activities are conducted solely within the location of a healthcare or life sciences conventions (the convention center blueprint) but maintained the meal ban and banning almost all other activities.
What’s Next?
The next hearing is set for Thursday, December 13h, 2018, at the Philadelphia City Council meeting. At that meeting, the bill is slated to undergo its second reading – the title will be read, and Council members will vote to approve the first reading. The entire bill is not read, just the title read aloud by the Chief Clerk.
If the bill passes the second reading, the bill is placed on the Second Reading and Final Passage Calendar for the next scheduled meeting.
After a bill is read for a second time, Council members may introduce amendments to the bill. If a bill is amended, it is then placed on the Final Passage Calendar at the next scheduled full Council meeting. If the bill is not amended, it can be voted on at the same meeting at which the second reading occurs. To pass, a bill must be approved by a simple majority vote (equal to nine members).
Once City Council has voted to approve a bill, it must certify by the signature of the Council President, attested by the Chief Clerk, and then sent to the Mayor within three days of final passage. If the Mayor signs the bill, it becomes law. Alternatively, if the Mayor ignores the bill and doesn’t do anything for ten days, it also becomes law.
If the Mayor vetoes the bill, it is sent back to Council and they have ten days to decide whether to put the bill to a vote again. If a supermajority of Council (12 members) approve the bill on the second go-round, they override the Mayor’s veto and it becomes law without the Mayor’s approval.
Analysis
The exemption that was given to the convention center:
Gifts provided to health care practitioners during a health care or life sciences convention organized through the PHLCVB, while such practitioners and pharmaceutical manufacturer’s agents are physically located at the convention.
The exemption can only be interpreted as if the event is held in the convention center you are permitted to provide meals, but if you happen to do your event in conjunction with a convention at hotel or restaurant you will be banned from buying a meal or any other transaction such as paying for a cab ride to the convention. It will probably ban all advisory board meetings held in conjunction with a convention. This essential is setting up the Philadelphia convention center property as a “duty free zone.”
It is not clear how a city can constitutionally ban commercial transactions by pharmaceutical manufacturers on physicians not practicing in the city or receiving payments from the city.
The bill could also have negative effects on one of the major employers for the city of Philadelphia Glaxo Smith Kline (GSK) as language is so broad, GSK could potentially be banned from bringing in clinicians for employment interviews or training for their physician employees.
This bill is being promoted as a solution to the opioid crisis but in Stat News last week William Greenlee, City Council member and bill sponsor readily admitted that “We’ll be the first to admit this won’t end the crisis by any stretch of the imagination and won’t affect folks already addicted.” Greenlee believes “there is a reasonable expectation that it will cut back on some of the overprescribing of medicines that lead to addiction.” But this bill is not directed at Opioid manufacturers, but all manufactures of all medicines including live saving medications where “overprescribing” as he defines it may detract from patient health.
Overall, there needs to be consideration for services not outlined in the ban and the City of Philadelphia would serve their community better by reinforcing local addiction programs. The bills author has his heart in the right direction but penalizing all companies who make all drugs including non-opioids is not necessarily a great solution to the opioid crisis.