New drug firm limits prompt fears of falloff in medical meetings in city

Boston's status as a popular destination for medical industry meetings - which generate tens of millions of dollars in revenue for hotels, restaurants, and the state - is at risk because of new regulations restricting financial relationships between pharmaceutical companies and doctors, according to industry executives.

The city hosted 2,500 medical and pharmaceutical company meetings in 2007 and 2008, attended by thousands of doctors and other clinicians; hotels earned $130 million from those meetings, while the state received about $16 million in tax payments, according to the Greater Boston Convention and Visitors Bureau. About 40 percent of the city's convention business is medical-related.

But now, with strict new regulations set to take effect July 1, some meeting sponsors are considering pulling out of Boston, said Patrick Moscaritolo, president of the convention bureau, who wants the state to delay im plementation of the law. At least two large medical conferences already have withdrawn.

One consumer group and a legislator who pushed for the law called the concerns far-fetched. Health Care for All, a Boston-based consumer advocacy group that is lobbying for even stricter regulation of industry interactions with physicians, said the medical groups are engaging in "fear-mongering" as a way to cast doubt on the new rules, which will be finalized within the next two months.

The American Academy of Allergy, Asthma and Immunology, however, wrote the convention bureau three weeks ago to say it has decided to relocate its 2015 annual meeting, with an estimated 8,000 doctors and other participants, which had been scheduled for the Boston Convention and Exposition Center. The group cancelled hundreds of rooms reserved for the meeting at the Westin Boston Waterfront. Conventions are planned years in advance.

Another group, the American Society of Gene Therapy, informed the convention bureau this week in writing that it has decided against booking its 2015 annual meeting in Boston because the regulations will "cripple the content and quality."

A third group, the Heart Rhythm Society, wrote to convention officials that it is reconsidering its commitment to hold five meetings in Boston between this year and 2021.

The groups said in the letters and in interviews with the Globe that one of their concerns is that the state's regulations, which establish a code of conduct for pharmaceutical company employees, will limit participation by drug company scientists in meetings and continuing medical education courses in Massachusetts.

The state's rules say that continuing medical education courses, which doctors must take to keep their licenses, must comply with guidelines issued by the Accreditation Council for Continuing Medical Education. Kay Whalen, executive director of the allergy academy, and David Bodine, president of the gene therapy society, said this requirement is a major problem. Those guidelines don't allow presentations by drug company employees, and Whalen believes that Massachusetts intends to go further by saying drug company scientists cannot present research even for courses not for education credit.

"Quite a bit of cutting-edge research is done by pharmaceutical companies and scientists want to hear it," Whalen said. "Our reading of this law is we could not have those sessions at all."

"That's absolutely false," said Amy Whitcomb Slemmer, executive director of Health Care for All. "Of course company scientists can present. But having providers get education credit for that is not appropriate. It's an advertisement."

Public health officials said the regulations actually do allow company scientists to present at meetings in Massachusetts, but with caveats: The presentations must present information in an objective fashion and cannot simply be promotional talks for the company's products.

Drug companies participate heavily in medical meetings across the country in other ways as well, by paying for meals and subsidizing tuition and by hawking their products to doctors from rows of exhibits set up on convention floors. The new regulations will prohibit companies with booths from distributing free merchandise to Massachusetts doctors, state public health officials confirmed.

The regulations written by state Public Health Department staff are intended to implement a law passed by the Legislature last summer, which bans companies from providing gifts to physicians, limits when companies can pay for doctors' meals, and requires companies to publicly disclose payments to doctors over $50 for certain types of consulting and speaking engagements. The law aims to control costs by reining in unnecessary prescribing of expensive drugs and to make doctors' potential conflicts-of-interest transparent to the public.

The new rules also govern drug company conduct at scientific meetings, professional conferences, and continuing medical education courses in Massachusetts. They allow firms to sponsor such meetings, as they do now, but with restrictions: Companies cannot pay for attendees' personal expenses such as travel and lodging, or pay them to attend. Companies cannot pay for meals for specific groups of doctors in attendance, but conference organizers can use pharmaceutical company funds toward meal costs for everyone. And, drug companies cannot dictate to conference organizers on the presentations made to physicians.

Tom Lyons, Public Health Department spokesman, said the agency received 1,000 pages of comments on the proposed regulations from 120 groups and individuals - the most on any regulation in recent memory. "We will give due consideration to every comment that has been submitted, but we believe we have a very balanced regulation," he said.

On the opposite side, consumer groups and others are heavily lobbying health officials to tighten the rules. One criticism by Health Care for All and some legislators is that companies will not be required to disclose payments to doctors for research-related activities.

The Public Health Council plans to approve a final version of the rules in February or March.

"I don't buy that this will have any material effect on the convention business in Massachusetts," said Senator Mark C. Montigny, a New Bedford Democrat who has pushed for years to ban industry gift-giving. "But even if it does, I would say it's completely irrelevant. We're talking about rules to protect the public health here."

Liz Kowalczyk can be reached at kowalczyk@globe.com.