Gifts and Meals
Q. Is it still permissible for a vendor to provide subscriptions to certain medical journals and copies of certain medical textbooks to a UMass Memorial department?
A. No. The new policy bans all gifts from industry, including pens, pads, hats, candy, medical journals, textbooks and other such items provided free of charge, which is not part of a contracted purchase.
Q. Why prohibit meals? Do they really affect patient care decisions?
A. Research has shown that even small gifts, such as pens, engender a sense of obligation on the part of the recipient. Moreover, research has shown that in cases where a doctor has a pen or pad advertising a particular product, that product gets prescribed more often (AMA Guidelines Regarding Industry Interactions; "Drug Makers Pay for Lunch as They Pitch," New York Times, July 28, 2006). Thus it has been shown that such gifts, including meals provided by "pharma" or device companies, can influence the decision-making process. The UMass Memorial goal is to provide our patients with the best, most objective care. This is why the Medical Center has chosen to eliminate such incentives.
Q. In the past, pharmaceutical or device reps provided lunch for meetings. Is this still allowed under the new policy?
A. No. As discussed above, our policy intends to eliminate the incentives such as meals. No meals may be provided nor directly paid for by industry anywhere on or off a UMass Memorial campus.
Under the new policy, industry may provide funds to the UMass Medical School/UMass Memorial Development Office to support continuing medical education at UMass Memorial. (The funds may not be provided directly to a clinical department or an individual). These funds may be used by clinical departments to support legitimate continuing education which may include provision of appropriate meals in an appropriate setting consistent with UMass Memorial policy.
Q. Can a sales representative take a doctor out to lunch or dinner for a business purpose?
A. No. Industry representatives should be invited to meet with UMass Memorial employed physicians by appointment in campus facilities. Because of the implied quid pro quo that such activities present, the new policy prohibits such restaurant meals with industry representatives.
Q. Can a vendor sponsor of a national/international meeting invite a UMass Memorial employed clinician/physician and other clinicians/physician meeting attendees to dinner following the meeting.
A. While our policy does not explicitly prohibit such a meal, we do not encourage these activities for the reasons stated above.
Industry Funding for Education
Q. Are UMass Memorial employed clinicians/physicians allowed to accept an invitation by a pharmaceutical or device company to give a talk to community physicians?
A. UMass Memorial policy allows employed physicians to consult if appropriate criteria is met, including but not limited to a contract for deliverables, restriction to scientific issues versus marketing, and compliance with Medical School consulting limitations. Such talks would be considered consulting. In instances in which UMass Memorial-employed physicians or staff participate in such talks, they should follow the guidelines below, which are included in the full vendor relationship policy.
- Financial support by industry is fully disclosed by the meeting sponsor.
- The meeting or lecture content is determined by the speaker and not the industry sponsor.
- The lecturer is expected to provide a fair and balanced assessment of therapeutic options and to promote objective scientific and educational activities and discourse.
- The lecturer is not required by an industry sponsor to accept advice or services concerning speakers, content, etc. as a condition of the sponsor's contribution of funds or services.
- The lecturer makes clear that content reflects individual views and not the views of UMass Memorial.
- The use of the UMass Memorial or UMass Medical School name in a non-UMass Memorial/UMass Medical School event is limited to the identification of the individual by his or her title and affiliation.
Q. May UMass Memorial physicians or staff participate on an industry speakers bureau if they are comfortable with the objectivity of lecture content?
A. No. The new policy prohibits participation in any industry sponsored speakers bureau due to concerns with the potential for and the appearance of compromised objectivity and the potential for implied quid pro quo.
Q. Is it still allowable for UMass Memorial departments to receive grants from industry for scholarships or other educational funds for students and trainees?
A. Yes, and in fact departments are encouraged to seek such funding, so long as the funding is donated to and administrated by the UMass Medical School/UMass Memorial Development Office, is specifically for the purpose of education and is free of any actual or perceived conflict of interest. It must also meet the following conditions:
- UMass Memorial, the Development Office or the clinical department selects the student or trainee.
- The department, program or division has determined that the funded conference or program has educational merit.
- The recipient is not subject to any implicit or explicit expectation of providing something in return for the support, i.e., a quid pro quo.
Q. While it is no longer permissible for pharmaceutical or device sponsors to purchase meals on or off campus, may they provide unrestricted gift funds to support research and education?
A. Yes. Our new policy does not allow industry to buy meals for UMass Memorial events on or off campus. However, the policy does allow pharmaceutical, device, and biotech companies to make gifts to the UMass Medical School/UMass Memorial Development Office to support continuing education activities and programs (funds may not be contributed directly to departments or faculty members). Programs and activities (for which food may be purchased) must comply with policy requirements which are generally aligned with the Accrediting Council on Continuing Medical Education's Standards for Commercial Support (ACCME). This will mean, among other things, that the faculty will determine the topics and the choice of speakers for the events funded by industry support. Pharmaceutical vendor representatives should not speak or disseminate promotional materials at any educational forum. Device vendor representatives should only speak at those educational forums where they are invited to speak as expert on the use of specific products. Device vendor representatives are permitted to distribute only those materials which serve predominantly educational purposes and not promotional purposes.
Q. Is it acceptable for industry sponsors to provide funding for quarterly grand rounds which are CME events and may be held off campus.
A. Yes, provided no vendor representatives will be present and no promotional materials of any kind will be distributed. Receiving such funding from industry sponsors is completely appropriate as is the above use of the funds. As discussed above, the funds must be contributed through the UMass Medical School/UMass Memorial Development Office and not the clinical department.
Q. Is industry support acceptable for fundraising events?
A. Yes, provided two requirements are met:
- There should be no vendor promotional materials at the event.
- Vendors are not permitted to purchase tickets to fundraising events and gift tickets to faculty members or clinical staff. If vendors wish to purchase tickets which they do not intend to use, these tickets may be gifted to a UMass Memorial department which, in turn should raffle the tickets or provide them to non-faculty, non-management personnel who are not involved in purchasing or other decisions which could involve or affect the vendor.
Q. If a UMass Memorial employee attends an annual educational conference, can the employee's travel and hotel costs be paid for by industry?
A. No, industry is never permitted to assume these costs directly. The policy allows a conference to cover reasonable travel and lodging costs, as well as payment of a reasonable honorarium only if the employee is leading or presenting at a conference. No honoraria, travel or lodging costs may be covered if the employee is simply attending the conference. If industry wishes to provide sponsorship for educational costs, they may make contributions through the UMass Medical School/UMass Memorial Development Office.
Q. Can pharmaceutical reps still pay for and attend Journal Club meetings, which are held at a local restaurant off-site?
A. No. The practice of industry representatives paying for such meals is not compliant with our new policy. If vendors wish to continue sponsoring Journal Club meetings they should contribute such funding to the UMass Medical School/UMass Memorial Development Office in support of continuing education. The UMass Memorial department would then have access to these funds provided programs and activities were consistent with policy criteria - including having a substantive educational purpose; appropriate and reasonable location; reasonable food/refreshments, etc.
Q. Can industry pay for educational brochures to be provided to patients?
A. No. Industry brochures may serve an educational purpose for either or both patients and caregivers. But they could also be perceived as promotional or create a sense of obligation for the department. Consequently, this would not be allowed. A company could make an educational gift to development of such materials through the UMass Medical School/UMass Memorial Development Office.
Q. Are industry product displays/product fairs permissible?
A. Product symposia or displays specifically requested or organized by UMass Memorial exclusively for the education of "clinical personnel," UMass Memorial patients or broader community are permissible if they meet the following requirements:
- A clinical department must invite the vendor(s) to conduct the product fair strictly for educational purposes of its "clinical personnel" or patient community.
- Products displayed must be directly related to the educational event or those specific products requested by the clinical department. The event must not be used in any way as a vendor product "promotional" event.
- There should be absolutely no gifts (bags, pens, mugs, hats, etc.) of any kind provided or distributed, nor should there be any promotional materials available or distributed. Only those materials directly related to the educational purpose of the event for which the vendor was invited are permitted to be distributed. All other materials including promotional brochures are prohibited.
- All meals should be funded by the clinical department.
- The product fair should preferably be conducted in an area of the clinical department, not the "main lobby," to preserve the educational purpose of the event.
Samples and Products
Q. Does the policy affect free samples for needy patients?
A. Yes and no. UMass Memorial supports the provision of free samples for intended use, including needy and indigent patients. To provide more effective oversight, any drug samples delivered to the three UMass Memorial Medical Center campuses must be received and administrated by the Medical Center's Pharmacy Department. Drug samples delivered directly to physicians are recognized as personal gifts and are not permitted under this policy.
Q. Can industry supply free materials for resident and student training?
A. No, because there is an implicit expectation that UMass Memorial would purchase these materials. Such purchasing decisions should be evaluated using objective criteria and must be free of any implied obligation.
Site Access by Sales and Marketing Representatives
Q. Under the policy, are sales and marketing reps allowed on UMass Memorial campuses?
A. Industry representatives are permitted in both patient-care and non-patient care areas only under very specific circumstances:
- Patient care areas: Industry representatives may be requested by medical staff, faculty or other designated clinical staff to provide in-service training on devices and other equipment - by appointment only;
- Non-patient care areas: Industry representatives may be permitted in non-patient care areas by appointment only.
Q. Is it true that sales and marketing representatives may no longer leave any written materials with employees?
A. This is correct. Sales and marketing materials from pharmaceutical or device companies may not be left with departments, medical staff, faculty, house staff or other staff or in any area of UMass Memorial. This is to ensure that we do not promote a company or its products within UMass Memorial, or to our patients.