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Pharmaceutical Speakers' Bureaus, Academic Freedom, and the Management of Promotional Speaking at Academic Medical Centers

Published online by Cambridge University Press:  01 January 2021

Marcia M. Boumil ,
Emily S. Cutrell ,
Kathleen E. Lowney  and
Harris A. Berman
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Extract

Pharmaceutical companies routinely engage physicians, particularly those with prestigious academic credentials, to deliver educational talks to groups of physicians in the community to help market the company's brand-name drugs. These speakers receive substantial compensation to lecture at events sponsored by pharmaceutical companies, a practice that has garnered attention, controversy, and scrutiny in recent years from legislators, professional associations, researchers, and ethicists on the issue of whether it is appropriate for academic physicians to serve in a promotional role. These relationships have become so contentious that three years ago the pharmaceutical industry trade association, the Pharmaceutical Research and Manufacturers of America (PhRMA), adopted voluntary guidelines stating that drug companies should stop giving doctors free pens, calendars, sports bags, or tickets to entertainment events. Further, numerous medical associations, such as the Association of American Medical Colleges (AAMC), the American Board of Internal Medicine (ABIM) and the Institute on Medicine as a Profession (IMAP), and government bodies such as the Institute of Medicine (IOM) have recommended that medical schools and teaching hospitals prohibit or strongly discourage faculty from participating in so-called industry Speakers Bureaus — promotional events designed solely to market pharmaceutical products.

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Independent
Information
Journal of Law, Medicine & Ethics , Volume 40 , Issue 2 , Summer 2012 , pp. 311 - 325
Copyright
Copyright © American Society of Law, Medicine and Ethics 2012

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The University of Colorado at Denver defines Speakers' Bureaus as “[c]ompensation by any pharmaceutical company, medical device manufacturer or manufacturer of other health-or nutrition-related products, or their subsidiaries, for speaking engagements whether on a one-time or recurring basis.” University of Colorado Denver School of Medicine, Faculty Senate Resolution on Conflicts of Interest and Speakers Bureaus, May 2011, available at <http://www.ucdenver.edu/academics/colleges/medicalschool/facultyAffairs/RulesPolicies/Pages/RulesPolicies.aspx> (last visited April 23, 2012). (last visited April 23, 2012).' href=https://scholar.google.com/scholar?q=113+The+University+of+Colorado+at+Denver+defines+Speakers'+Bureaus+as+“[c]ompensation+by+any+pharmaceutical+company,+medical+device+manufacturer+or+manufacturer+of+other+health-or+nutrition-related+products,+or+their+subsidiaries,+for+speaking+engagements+whether+on+a+one-time+or+recurring+basis.”+University+of+Colorado+Denver+School+of+Medicine,+Faculty+Senate+Resolution+on+Conflicts+of+Interest+and+Speakers+Bureaus,+May+2011,+available+at++(last+visited+April+23,+2012).>Google Scholar
This approach has been taken by the Tufts University School of Medicine, Boston University School of Medicine, and the University of Pittsburgh Schools of Health Sciences.Google Scholar
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See, e.g., Duke University School of Medicine, COI and Industry Relations, available at <http://medschool.duke.edu/modules/som_interests/index.php?id=7#Speaking%20Relationships> (no longer available online.) Duke's policy allows participation in industry Speakers' Bureaus if “(1) the activity promotes evidence-based clinical care and/or advances research; (2) financial support is appropriately disclosed; (3)…financial compensation [is pursuant to] a speaker's contract; (4) compensation…[is] reasonable (i.e. fair market value); (5) [the] lecture material represents a balanced assessment of current clinical and/or scientific treatments; [and] 6) the speaker discloses that the [content] represents his or her [own] views and not [just that of the industry sponsor].”+(no+longer+available+online.)+Duke's+policy+allows+participation+in+industry+Speakers'+Bureaus+if+“(1)+the+activity+promotes+evidence-based+clinical+care+and/or+advances+research;+(2)+financial+support+is+appropriately+disclosed;+(3)…financial+compensation+[is+pursuant+to]+a+speaker's+contract;+(4)+compensation…[is]+reasonable+(i.e.+fair+market+value);+(5)+[the]+lecture+material+represents+a+balanced+assessment+of+current+clinical+and/or+scientific+treatments;+[and]+6)+the+speaker+discloses+that+the+[content]+represents+his+or+her+[own]+views+and+not+[just+that+of+the+industry+sponsor].”>Google Scholar
The University of Pennsylvania and Duke have adopted this approach.Google Scholar
The University of Pennsylvania policy states that “professionals should not participate in Industry marketing activities” but, of course, this falls short of an absolute prohibition. The University of Pennsylvania also allows faculty to “accept reimbursement (of travel, meals, and other expense) for presenting research findings at a meeting, presenting on clinical topics…provided that the expenses are reasonable in relation to the services provided (fair market value).” Though the Chief Medical Officer of University of Pennsylvania recently stated that he believed UPENN's policy's prohibition on marketing includes delivering drug-company lectures, the “fair market value” caveat along with the “should” seems to imply that at least some industry marketing “presentations” are fair game. See Hospital of the University of Pennsylvania/Clinical Practices of the University of Pennsylvania: Clinical Practice Guidelines. Guidelines for Interactions between Health care Professionals and Industry, effective September 26, 2006, available at <somapps.med.upenn.edu/fapd/documents/ext00159.pdf> (last visited April 29, 2012). (last visited April 29, 2012).' href=https://scholar.google.com/scholar?q=118+The+University+of+Pennsylvania+policy+states+that+“professionals+should+not+participate+in+Industry+marketing+activities”+but,+of+course,+this+falls+short+of+an+absolute+prohibition.+The+University+of+Pennsylvania+also+allows+faculty+to+“accept+reimbursement+(of+travel,+meals,+and+other+expense)+for+presenting+research+findings+at+a+meeting,+presenting+on+clinical+topics…provided+that+the+expenses+are+reasonable+in+relation+to+the+services+provided+(fair+market+value).”+Though+the+Chief+Medical+Officer+of+University+of+Pennsylvania+recently+stated+that+he+believed+UPENN's+policy's+prohibition+on+marketing+includes+delivering+drug-company+lectures,+the+“fair+market+value”+caveat+along+with+the+“should”+seems+to+imply+that+at+least+some+industry+marketing+“presentations”+are+fair+game.+See+Hospital+of+the+University+of+Pennsylvania/Clinical+Practices+of+the+University+of+Pennsylvania:+Clinical+Practice+Guidelines.+Guidelines+for+Interactions+between+Health+care+Professionals+and+Industry,+effective+September+26,+2006,+available+at++(last+visited+April+29,+2012).>Google Scholar
This approach has been taken by Weill Medical College of Cornell University and Tulane University.Google Scholar
The Cleveland Clinic requires disclosure of industry relationships on a public website but does not restrict industry speaking.Google Scholar
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