The Case:
Pepe LaTour is director of education at King Rex University Medical School in New Orleans. Each year he plans a lavish and festive dinner the evening of Fat Tuesday. This year the dinner occurs at the conclusion of a two-day CME-certified infectious disease course funded by Pharma-to-U Inc., and coincides with the school’s 100th anniversary. School deans, directors, medical students, residents, alumni, pharmaceutical representatives, and the supporter’s grant department staff have been invited to the course’s closing session for a champagne toast. Also invited is the supporter’s chief scientific investigator, Dr. Michael Petri.

As the course concludes Tuesday afternoon, all invited guests and course participants are assembled for the toast when Pepe makes an unscheduled announcement—everyone is invited for cake to mark the 100-year anniversary of the medical school. With that a large bell rings, and in rolls a four-foot-tall cake covered with Mardi Gras–colored icing. Attached to the cake is a mechanical arm tossing purple, green, and gold trinkets bearing the logo of the supporter’s ID division. Dr. Petri examines the baubles and is mortified by what he sees and embarrassed in front of the distinguished crowd. Although he says nothing at the time, he silently vows to call Pepe the following morning.

Half-Baked Idea Leads to Ethical Concerns
Should the logo-embossed trinkets be of concern to Pharma-to-U?
Parochka: First, participants and guests might assume the pharmaceutical company supporting the course approved of Pepe’s actions, and second, that Pharma-to-U’s grant department purchased the cake and trinkets that were distributed at the end of the course. Will guests suspect the commercial supporter wanted to advertise its lead product by distributing trinkets? This was a deep concern for
the supporter in a scenario this case is based on.

Overstreet: In this era of hyper-sensitivity, perception of bias and impropriety can be as important as overt violations. What was Pepe’s rationale for using the supporter’s logo? Even though the school, not the grantor, funded the trinkets, attendees may mistakenly believe that the supporter had a role in the celebration and that the trinkets are advertising. And the supporter may fear some would believe the Pharma Code is implicated, even though the company had nothing to do with funding the items that were distributed to healthcare professionals or sanctioning the social event.
 

What might Dr. Petri want to address during his conversation with Pepe?
Parochka: If I were Dr. Petri, I would insist Pepe write a letter of apology to Pharma-to-U indicating that he did not receive prior approval for his actions, and that the school planned and funded the social event independently. In addition, Pepe’s letter should substantiate that supporter funds were not used to cover the costs of the unannounced event or the trinkets. It would be ideal if course participants and invited guests were also notified of Pepe’s unilateral action.

Overstreet: Pepe certainly seems guilty of poor judgment. He could take this as an opportunity to review best practices, school policy, and regulations regarding gifts to HCPs and the use of commercial interests’ logos. He and his staff need to ensure that they clearly understand the need to keep certified education separate from social events—and from promotional activities—as they plan new courses.