University Times

Pitt and UPMC are among the top institutions nationally for best conflict-of-interest policies, according to a report issued last week by the American Medical Student Association (AMSA).

Pitt/UPMC was one of only eight institutions out of 150 surveyed to receive an A grade, according to the AMSA PharmFree Scorecard released June 3 (www.amsascorecard.org).

AMSA, a group of about 67,000 medical students, residents and practicing physicians, collaborated with the Prescription Project, an industry watchdog group working to eliminate conflicts of interest in medicine, to develop a methodology and an interactive web site that evaluates each institution’s policies in 11 areas.

The AMSA PharmFree Scorecard evaluates restrictions on gifts, paid speaking for products, acceptance of drug promotion samples, interaction with sales representatives and industry-funded education, among other criteria.

In February, UPMC enacted stricter conflict-of-interest policies that govern UPMC employees, as well as faculty, staff and students at Pitt’s Schools of the Health Sciences and representatives of drug companies seeking their business.

Pitt/UPMC’s policy prohibits gifts such as note pads, pens and food from industry representatives. The policy also includes restrictions on consulting relationships and attendance at pharmaceutical industry-sponsored meetings, among other provisions.

In addition to Pitt/UPMC, top-ranked institutions include: Mount Sinai School of Medicine (New York), the Uniformed Services University of the Health Sciences (Maryland), the University of California-Los Angeles David Geffen School of Medicine, the University of Massachusetts Medical School, the University of Pennsylvania School of Medicine, the University of California-Davis School of Medicine and the University of California-San Francisco School of Medicine.

According to the scorecard, 13 respondents received a B grade; four received a C; 19 received a D, and 60 received an F, including 15 that either submitted policies graded as F or indicated they had no relevant policies. Sixteen schools declined to submit policies and 29 did not respond. Thirty-one responding institutions received a grade of “in process” because their policies currently are under review or revision. An additional 15 participants submitted policies after initial scoring had been completed and have been assigned a temporary “in process” designation.

According to press materials accompanying the AMSA report, “pharmaceutical industry marketing to doctors has been estimated at $28 billion to $46 billion per year, with additional promotion by the medical device industry. This equates, conservatively, to $35,000 per year in marketing directed at each physician, on average.

“More than 100,000 pharmaceutical sales representatives regularly visit U.S. physicians, providing free lunches, gifts, medication samples and carefully selected medical literature to promote their products. These presentations and personal relationships are designed to influence doctors to prescribe more drugs and more expensive drugs and have often become a substitute for objective medical evidence.”

—Peter Hart