State health council approves regulations that let companies pay for doctors’ meals and drinks

Following the lead of the Legislature and the Patrick administration, the state Public Health Council adopted regulations Wednesday loosening a gift ban that is part of state law restricting marketing by drug and medical device makers.

The new rules had been expected since July when the budget signed by Governor Deval Patrick included an amendment permitting companies to pick up doctors’ tabs for “modest” meals and refreshments—including alcoholic beverages—served during informational sessions about their products. But critics said they were disappointed the regulations failed to heed calls to prohibit alcohol or set a dollar limit on the amount drug and device companies can spend.

“It’s not a great day for health care consumers in Massachusetts,” said Amy Whitcomb Slemmer, executive director of the Boston advocacy group Health Care For All, which called for tougher regulations. “It’s hard to fathom how alcohol plays a part in an educational setting. This is a step back from the gift ban that we’ve had in effect in the state since 2008.”

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But Whitcomb Slemmer said Health Care for All was encouraged by the Public Health Council’s promise to revisit the issues of capping meal prices and restricting alcoholic beverages after Department of Public Health staff reviews data over the next six months about how much is spent on food, beverages, and venues for educational sessions.

“We were implementing the will of the Legislature,” said Dr. Alan Woodward, a health council member. “But we requested that information be collected to determine whether the appropriate balance required further restrictions to avoid undue influence.”

The rules require drug and device companies to report the location of presentations they make to doctors, a description of products discussed, the total amount spent, and an estimate of the sum spent for each participant for meals and refreshments. Under an amendment proposed by Woodward and passed by the council, interim public health commissioner Dr. Lauren Smith, was empowered to also require additional reporting.

Representatives of the state’s restaurant and entertainment businesses had joined biopharmaceutical and medical technology executives in lobbying to weaken the Massachusetts gift ban, which they said was the nation’s most restrictive. The drug and device industries still have to comply with a code of conduct that prohibits them from giving doctors gifts such as pens, mugs, and calendars, and paying for tickets to shows and concerts.

“We still have the tightest requirements in the country by far,” Woodward said.

But others, including consumer advocates, medical students, residents, and some physicians and lawmakers, wanted this year’s budget amendment to cap the amount that can be spent, and to prohibit alcohol.

At a Wednesday health council meeting, Thomas Brophy, general counsel for senator Mark C. Montigny, a New Bedford Democrat, read a statement on Montigny’s behalf saying the proposed regulations “fly in the face of the legislative intent” of the original gift ban passed to limit the influence of pharmaceutical and medical device makers.

Iyah Romm, director of policy, health planning, and strategic development at the state public health department, told the council “it has become clear there are many diverse perspectives” regarding the rules, based on testimony they received during public hearings on the proposed regulations this fall. He said health officials saw an “even split” of opinions.

On including a ban on alcohol, an issue not addressed by the budget amendment, Romm said “we do not feel it’s appropriate for the council” to dictate what is served at educational functions. He added that the department expects alcohol use at functions to be “appropriate.”

Several council members expressed strong objections to allowing alcohol at events sponsored by drug and device makers, saying it runs counter to an educational setting.

“Show me the medical school that offers beer to its students before they go into class,” said Dr. Muriel R. Gillick, staff physician at Harvard Vanguard Medical Associates and a council member. “If we are to define a modest meal, we should be able to define something about the content of the meal as well as the value of the meal. And if other bodies haven’t had the wisdom to define this, we can.”

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