HCEA Attendees Voice Concern Over New PhRMA Code The biggest buzz at the Healthcare Convention & Exhibitors Association annual meeting in Toronto this week was, not surprisingly, the potential impact of the new voluntary ethical code issued by the Pharmaceutical Research and Manufacturers of America (PhRMA), which goes into effect on July 1.

To address those concerns, Timothy Casady, deputy general counsel, Eli Lilly and Co., gave a special presentation on PhRMA’s Code on Interactions with Healthcare Professionals before a packed crowd of pharmaceutical company and association planners full of questions. The nine-point code covers many of the same issues as the current American Medical Association (AMA) and Accreditation Council for CME (ACCME) guidelines, including informational events, gifts to doctors, and the independence of accredited continuing medical education.

"If we didn’t take the lead, Congress would have done it for us," said Casady, citing media pressure, recent kickback scandals, and the overall industry environment. Still, he reassured, "it is not a retreat from the industry’s basic business model," which has pharma money going directly to the meeting organizer, who controls content and faculty to ensure the education is unbiased. It does, however, call for some significant rollback in pharma spending on social events, which now must be "modest," and disallows spouse attendance, which many think will drop attendance at these events dramatically.

Outside of his session, some planners said they thought the new code, which replaces PhRMA’s decade-old original ethical code, may just be a correction, which many noted happens cyclically about every10 years. "Things’ll tighten up for a while, then relax," said one pharma planner. "By 2012, we’ll probably need a new set of rules to rein things in again." Others said they believed the tightened rules are here to stay—at least until there is no more risk of a TV show’s crew skulking undercover at a pharma-supported reception.

While the code has to be voluntary due to antitrust issues, pharma CEO involvement in the drafting of and commitment to the code would seem to ensure that compliance will be high on their to-do list. Still, Casady said, there are still many gray areas, such as how the code should be applied to non-U.S.-affiliated pharma sponsors, and what kinds of titles are covered under "health care provider"; i.e., if the doctor’s spouse is also his office manager, is it OK for the spouse to attend a social event? The bottom line is that you must appear to be making a good-faith effort to follow the spirit of the code, even if it’s not spelled out explicitly, he said.

"If you really believe in the code, you’ll bend over backwards to make your meetings compliant," he said. The consensus at HCEA seemed to be that everyone will have to wait and see how it all shakes out in the short and long term.

In the meantime, where will that money not being spent on lavish parties go? Most HCEA attendees seemed to think it would be plowed back into CME, which brought smiles to the medical society planners. But Casady brought down the house when he said, "Where’s that money going to go? To consultants paid to train people about the new code!"