A drug company sales representative visits your office. He hands out ballpoint pens, notepads, and a coffee mug, all printed with the brand name of his company's eyedrop. He asks for nothing in return. Your practice follows the PhRMA Code on Interactions With Health Care Professionals. What should you do with the items?
You should decline the pens, notepads, and mug. PhRMA stands for the Pharmaceutical Research and Manufacturers of America. Its voluntary code took its current shape in 2009, and it bans practice-related gift items that carry a company name or logo. The code names these exact examples: pens, notepads, mugs, and similar reminder items. Low value is not an excuse. Items of minimal value are explicitly prohibited, so cost does not change the answer.
The reason is influence. A logo that sits on your desk all day is advertising inside the exam lane. It can nudge prescribing in ways that do not serve the patient. The code does allow a narrow group of items. A representative may leave things that relate to a patient's disease or teach the patient, such as an eyedrop instillation handout or an anatomy model. Meals are allowed only with a legitimate educational presentation. Tickets, sporting goods, and trips are banned outright, even for a doctor who speaks for the company. Payment to speakers and consultants must match fair market value. These rules are written for physicians, but staff must follow them too. An assistant who takes a banned item puts the whole practice out of step with the code. Many offices, especially teaching centers, set even stricter policies and refuse all materials and samples.
Learn your own office policy, then apply the tighter of the two rules. Knowing what a drug representative may and may not give you belongs to the COA content area on medical ethics, legal issues, and regulatory issues.
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