Massachusetts Code of Conduct: Creating a Collaboration Gap
The Boston Business Journal recently highlighted the “Collaboration Gap” that is being caused by the gift ban in Massachusetts, which has kept doctors “in the dark” and is “hurting innovation.”
For example, Dr. David Miller, an allergy and asthma doctor from North Dartmouth, recently attended a booth at a conference, which had a sign that said “doctors from Massachusetts couldn’t take a cup of yogurt.” Dr. Miller thought such a display was “insulting.” He noted that “if he could be bought for a yogurt, he was in the wrong business.”
This sign was particularly irritating to Dr. Miller, an asthma specialist who has previously been a clinical researcher for potential new drugs, because it reminded him how the “talks he often gave to peers about the latest treatments at events paid for by drug companies, have been completely halted.”
His experience with the Massachusetts gift ban law has also been frustrating because “invitations to events have been curtailed, and he suspects that his recent application to serve on the medical advisory board of a pharmaceutical company was rejected because the company did not want to deal with the onerous reporting requirement mandated by the law.”
And to show just how fed up he is with the gift ban Dr. Miller “took the yogurt and said arrest me.”
Dr. Miller expressed his distaste with the gift ban because critics who support such bans are misguided. As he pointed out, “never in his talks did he endorse a specific product because it’s actually forbidden by the code established by PhRMA.” So to him, the idea that he was trying to get doctors to prescribe a particular brand or more expensive treatment is completely wrong.
Interestingly, because there are numerous other physicians and health care providers like Dr. Miller who are dissatisfied with the gift ban, the pressure to repeal the law “is gaining momentum.” Although the repeal, which was recently “approved by the House faces an uphill battle in the Senate, where the gift ban has previously been supported by Senate President Therese Murray,” a recent survey conducted by Dan Wolf may provide the evidence needed to overcome this hurdle.
According to the recent graduate of the joint Harvard/MIT Biomedical Enterprise program, “the most surprising thing he found is that the majority of doctors felt that the ban would hurt patient care long-term.” Wolf’s research also showed evidence that the “burden of the ban is particularly acute in the medical device industry, where much of the innovation comes after market approval, when doctors advise companies on their experience using devices such as heart stents or knee implants.”
As our previous summary noted, the results of Wolf’s survey also found that most doctors surveyed, 83%, said the law has “led to an impaired ability to collaborate with industry to develop new devices.” This kind of finding was particularly disturbing to Massachusetts House Speaker Robert DeLeo, who said the law “conflicts with other economic development efforts to attract companies to the state, and it hurts the convention business.” DeLeo further added that the law “has gone too far” by trying to outlaw giving someone a boxed lunch at a conference.
Supporters of the gift ban, such as Brian Rosman, policy director at the nonprofit Health Care for All, believe that the law is designed to drive health care costs down, to date no evidence has proven such a claim. Although Rosman cited data from the Division of Insurance, which showed that drug costs have risen more slowly than other health care costs in the past year,” he acknowledged that there is no way of knowing that “the gift ban is responsible.”
Despite the lack of evidence to support the continued use of the gift ban, and in fact, the growing evidence that has shown the damage it has caused thus far, the original sponsor of the legislation, Massachusetts State Senator Mark Montigny, is “determined to keep it from being overturned.” Mr. Montigny said that “the doctors and patients he has talked to say they are glad to be rid of the intrusion (of drug sales reps) into the doctor-patient relationships.” But such conversations are clearly contrary to the results and concerns displayed in the Wolf survey, which overwhelmingly demonstrate that doctors are worried about the negative impact the gift ban will have on the future of patient care.
But the fate of the gift ban is still undecided, with the Massachusetts Senate “announcing last week that it will not concur with the House version of the Economic Development bill.” As a result, the Senate has appointed “members to serve on a conference committee to work out the differences, giving them two weeks to agree on a final bill before the legislature adjourns for the session.”
Although Montigny maintains that the repeal of the gift ban “does not belong in the economic development bill,” he is clearly ignoring the financial devastation the ban will cause to doctors, medical device companies, and health care providers, as demonstrated in Wolf’s survey. Moreover, members of the House are not just responding to the “pander of a few whining restaurants and the entertainment industry who have lost business as a result of the ban,” as Montigny suggests.
Policymakers in Massachusetts are finally beginning to listen to the thousands of patients and doctors who are seeing the quality of their health care slip away. Patients cannot afford to wait around to see if such bans will really lower health care costs because while that data is being collected, research will be hindered since device makers will not be able to interact with doctors to create newer innovations and update old ones.
Instead of trying to see if the money already wasted on the gift ban will have its intended effects, it would be more cost effective to repeal the ban now, and put all the money into more research to help collaboration between academia and industry develop drugs and treatments for deadly diseases. Otherwise, if patients are left with fewer options for treatment because device and drug makers are banned from working with doctors, the health care costs will only grow exponentially by the number of untreated problems patients will experience while waiting for something to come through the pipeline.