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Author Topic: Universitäten schotten sich gegen Pharmalobbyismus ab  (Read 823 times)


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Universitäten schotten sich gegen Pharmalobbyismus ab
« on: September 13, 2006, 08:48:52 PM »

Pressemeldung vom 12.9.2006:

09/12/06 News Release
PRINT MEDIA CONTACT: Ruthann Richter at (650)
725-8047 (
(650) 723-6912 (


STANFORD, Calif. - Stanford University Medical
Center has joined a small cadre of other major academic
medical centers in enacting a policy aimed at limiting the
potential influence of pharmaceutical and other biomedical
companies in its day-to-day clinical and educational

The new policy prohibits physicians from accepting
industry gifts of any size, including drug samples, anywhere
on the medical center campus or at off-site clinical facilities
where they may practice. Among its other provisions, it
bans pharmaceutical, bio-device and related industry
representatives from patient care areas and medical school
facilities except for in-service training on devices and
equipment and by appointment only, as well as allowing
industry support of educational activities only under
well-regulated conditions.

The policy takes effect Oct. 1.
While the policy recognizes the value of industry
collaborations, which help speed the availability of vitally
needed drug treatments, it aims to ensure that
doctors’ and scientists’ interactions with
industry are ethical and avoid conflicts of interest that could
affect patients and the integrity of the school’s
training programs.
“We do not want industry dollars to have the
potential to influence how we train people or give clinical
care, and I think this document sets out ways of minimizing
this potential,” said Harry Greenberg, MD,
professor of medicine and chair of the 23-member School
of Medicine task force that developed the policy. He noted
that the medical school already has a strong, long-standing
policy that governs conflicts of interest in research activities
and that the new policy will complement it by minimizing
potential conflicts in the clinical and educational arenas.
The new policy was unanimously approved June 16 by the
medical school’s executive committee and was
adopted in August by the medical boards at Stanford
Hospital & Clinics and Lucile Packard Children’s
Hospital. It applies to all physicians who practice at the two
hospitals, including community physicians and the research
faculty in the School of Medicine.
The policy puts Stanford in the forefront of a small but
growing movement among academic medical centers to
manage potential conflicts of interest created by the
widespread marketing practices of the pharmaceutical
industry. Of the $21 billion the pharmaceutical industry
spends every year on marketing, as much as 90 percent is
directed at physicians through various mechanisms, such as
free meals, gifts and drug samples and sponsorship of
continuing medical education programs and other events,
according to an article published Jan. 25, 2006, in the
Journal of the American Medical Association.
These marketing practices have the potential to influence
physician practice patterns, including the drugs doctors
prescribe. Although the majority of physicians queried in
national surveys say they don’t believe they
personally are swayed by industry tactics, they believe a
majority of their peers are.
Philip Pizzo, MD, dean of the School of Medicine, said he
has been concerned for some time about the pervasive
presence of the pharmaceutical industry in the medical
profession, an issue that’s been highlighted in recent
years in news articles, books and the medical literature. He
began a discussion in the Stanford medical school
community on the issue through his “Dean’s
Newsletter” in the summer of 2005; last fall, he
asked Greenberg, who is senior associate dean for
research, to convene a task force to draft a policy.
“In recent years we have witnessed an erosion of
the public trust in the profession of medicine and even in
the value of science,” Pizzo said. “Part of
that is related to the market forces that have increasingly
converted medicine from a profession to a business, but a
significant factor has also been the perception that
physicians and scientists may be accepting gifts and
gratuities from industry at the very time that the cost of
drugs is skyrocketing.
“It is essential that medical professionals and
scientists reclaim the moral high ground and avoid the
appearances of conflict of interest that can otherwise cloud
or alter the trust of the American public. It is my hope that
the stance being taken by Stanford will serve as beacon of
responsibility for the medical and scientific
The policy is modeled in part after one approved in 2005
by the Yale Medical Group. The Hospital of the University
of Pennsylvania also approved guidelines for interactions
with pharmaceutical industry earlier this year, and a few
other academic medical centers have said they’re
considering similar policies, which are being encouraged by
the Association of American Medical Colleges.
Stanford’s policy is broader than those of its
counterparts in that it regulates devices, the biotech,
hospital and research equipment and supply industries, as
well the pharmaceutical industry throughout the medical
center including laboratory research facilities.
The policy declares that it is “unacceptable for
patient care decisions to be influenced by the possibility of
personal financial gain” and exhorts physicians to
divorce all clinical care decisions from any benefits they
may receive from a company.
“I feel it’s very important for physicians to
avoid situations where there is a conflict or an appearance
of a conflict with respect to pharmaceutical and device
companies,” said Harvey Cohen, MD, PhD, the
Adalyn Jay Chief of Staff at Packard Children’s
Hospital. “This policy, by intent and content, goes a
long way in helping ensure that this happens.”
The policy specifically prohibits Stanford physicians and
scientists from accepting gifts from companies, however
small. Doctors are already prohibited from accepting
“substantial” gifts—i.e. those valued
at more than $100—under guidelines developed by
physician groups such as the American Medical Association
and the Accreditation Council for Continuing Medical
Education. But small gifts, such as logo pens, pads, tote
bags and drug samples, are still common accoutrements in
doctors’ offices, both at Stanford and elsewhere.
David Magnus, PhD, director of the Stanford Center for
Biomedical Ethics and a member of the task force, said
studies suggest that small gifts can have as much of an
influence on physician thinking, prescribing and purchasing
habits as large gifts.
“Gift giving creates a reciprocal obligation that is a
powerful force, and pharmaceutical companies know this
very well,” he said. “So we’re
discouraging it from happening anywhere at the medical
Larry Shuer, MD, chief of staff at Stanford Hospital and a
professor of neurosurgery, said he’s “certain
that most medical staff would feel that they are not
influenced in their medical decision-making by free pens or
doughnuts from an industry representative. However, we
all agree that the appearance of possible conflict is what we
must try to avoid, as the public perception may be different
from that of the physicians.”
The policy also bans pharmaceutical sales and marketing
representatives from entering patient care areas and only
allows them access in non-patient care areas, such as
research laboratories, by explicit invitation. The presence
of pharmaceutical representatives on patient wards is
considered inappropriate and unnecessary, Greenberg
noted, particularly in this era of digital technology, in which
physicians no longer need pharmaceutical representatives to
supply them with up-to-date medical literature
that’s now readily available on the Web.
Vendors selling medical equipment also would not have
access to the hospitals or medical school without an
appointment. Faculty members involved in purchasing
equipment would have to disclose any financial
relationships they or their family may have with the
company in question and could be excluded from the
decision-making process.
In addition, the policy states that companies cannot pay for
meals for faculty members or trainees for Stanford
activities on or off campus except under the strict
guidelines set by the ACCME, and it provides guidelines
for participation in industry-sponsored events off campus.
For instance, even if a company provides funding for food
for a given program, it cannot control the speakers or the
content of the program, which would have to present a
balanced view of therapeutic options. Those involved in
planning the program would have to disclose any relevant
financial relationships. What’s more, no industry
sales and marketing representatives could be present during
an educational activity, and no promotional materials could
be handed out.
The policy also contains provisions that prohibit faculty
from publishing articles in medical journals that have been
ghostwritten by industry representatives, and reinforces
existing practice that faculty disclose related financial
interests in any papers they publish or presentations they
make. Greenberg said he doesn’t know how
common it is for Stanford faculty to submit ghostwritten
papers, but that it’s a common industry practice
that he believes is inappropriate.
In addition, the policy mandates that all residents, trainees
and staff be educated about potential conflicts of interest in
interactions with industry.
Richard Popp, MD, emeritus professor of cardiology and a
former senior associate dean of faculty affairs at the
medical school, said he believes the policy is important in
terms of protecting patients. “The idea is that a lot
of marketing activities of the pharmaceutical industry are
aimed at inducing doctors to use certain drugs and the
question is, are they using a particular drug because they
were seduced by the pharmaceutical industry or because
it’s best for the patient? The fact is you always
have to do what’s best for the patient.”
But, he added, balancing that imperative with the need to
maintain ethical working relationships with industry can be
a challenge.
“I think it’s worthwhile to call attention to
the subtle influence of industry, especially when it comes
to the marketing of drugs, and gifts and taking people to
dinner and so on. That has to stop,” Popp said.
“But saying industry is bad and we should not have
anything to do with industry is not a good idea. There are a
lot of things we could not do without the help of industry.
So we have to work ethically together for the benefit of
# # #
Stanford University Medical Center integrates research,
medical education and patient care at its three institutions -
Stanford University School of Medicine, Stanford Hospital
& Clinics and Lucile Packard Children's Hospital. For
more information, please visit the Office of Communication
& Public Affairs site at
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