Gov. Chris Christie’s administration has proposed new rules to prohibit or limit what doctors or other medical practitioners can take from drug companies. If you’re thinking there already should be rules about this, you would be right. The state boards of medicine, dentistry and optometry already have rules regarding gifts to prescribers from drug manufacturers. And the Pharmaceutical Research and Manufacturers of America, or PhRMA, has a code of ethics regarding such gifts.
But Attorney General Christopher Porrino says New Jersey’s proposed new rules clarify and strengthen existing rules. The idea, of course, is to ensure that medical practitioners are basing the prescriptions they write on patients’ best interests — not on which drugmaker provides the fanciest lunch or pays the most in speaking fees.
The existing rules generally prohibit pharmaceutical manufacturers from providing medical professionals with anything of more than negligible value as an inducement to prescribe a particular product. Those rules, however, have exemptions big enough to drive $69 million through, which is the amount that New Jersey prescribers received from drug and medical-product manufacturers in the last year alone.
“More disturbing,” the attorney general’s office says, “the Top 300 of the 30,000 New Jersey doctors listed received two-thirds of the $69 million, in a median amount of $62,500. Thirty-nine doctors were reported as having been paid at least $200,000.”
The proposed rules would, among other provisions, limit doctors to accepting no more than $10,000 per year from all pharmaceutical manufacturers, excluding “fair-market payments for speaking engagements at continuing education events.” Meals provided to doctors would be limited to four times each year, and the cost of the food and beverage could not be more than $15 per prescriber. Prescribers would even be prohibited from accepting “pens, note pads, clipboards, mugs or other items with a company or product logo.”
The level of detail that the AG’s office apparently feels necessary is a little disturbing. Would a doctor really prescribe a dangerous opioid when a safer alternative is available just because he or she had chicken parmesan for lunch instead of a hot dog?
It may be easy to blame the pharmaceutical companies here. But they are trying to do what companies do in a free market — sell their product. Doctors are expected to answer to a higher authority. They have a moral and professional obligation to do no harm. Frankly, we think they should abide by the principle that smart people in government abide by: Take nothing from nobody.
Opioid addiction is, of course, a personal tragedy. But the levels of addiction seen today are increasingly a major social — and business — problem. Almost 80 percent of drug users are employed, according to some estimates. Think loss of productivity, employee turnover and burdensome human resources issues, among other problems for businesses.
And, too often, it all starts with a doctor’s prescription pad. Many doctors say they have been made scapegoats in the opioid crisis. To some degree, perhaps. But that $69 million paid to prescribers by drug manufacturers undermines that complaint. Why shouldn’t the figure be zero?