In the midst of increasing calls to ban pharmaceutical companies' gifts to
physicians and medical students, a recent report from the American Medical
Student Association (AMSA) says that most U.S. medical schools do not have
adequate policies to address conflicts of interest involving industry
In a survey of 150 medical and osteopathic schools, 21 (14 percent)
received grades of A or B for their conflict-of-interest policies, while 60
schools (40 percent) received a failing grade, according to a June 3 AMSA
announcement. The survey, known as the AMSA PharmFree Scorecard, was conducted
by the organization in collaboration with the Prescription Project, an
industry watchdog group created by the Pew Charitable Trusts.
The scores were derived from assessments of each school's
conflict-of-interest policies regarding acceptance of gifts and meals from
industry, interaction with sales representatives, consulting and speaking
relationships, disclosure of financial conflicts, financial support for
educational events, and other issues.
Seventy percent of the schools contacted responded to the survey. The 16
schools that declined to submit their policies and 29 that did not respond to
multiple requests were graded F. Another 28 schools (19 percent) told the
surveyors that they were currently revising existing policies or creating new
ones; these schools were given a grade of "incomplete."
The AMSA scorecard echoes a study published in JAMA last year that
found extensive relationships between the industry and medical schools and
teaching hospitals. The JAMA study also found that
conflict-of-interest policies vary widely on permissible relationships between
faculty and industry, and many policies were under revision (Psychiatric
News, April 18).
The financial relationships between industry and medicine are under
increasing scrutiny, with demands from within and outside of the profession to
increase and tighten regulations. The Association of American Medical
Colleges' task force on industry funding of medical education released a
report in April that urged medical schools to "prohibit the acceptance
of any gifts from industry by physicians and other faculty, staff, students,
and trainees of academic medical centers, whether on site or off
The task force report also recommended that schools restrict access by
pharmaceutical representatives to students and trainees and prohibit
industry-funded travel, food, and meals (except food provided in connection
with continuing medical education programs accredited by the Accreditation
Council for Continuing Medical Education). When medical schools across the
country will adopt these guidelines remains uncertain in light of the AMSA
"It is time to extricate marketing practices from medical
education," Brian Hurley, president of AMSA, said in a press release. In
2002 AMSA began its PharmFree campaign, "a national movement to limit
the access and influence of pharmaceutical companies at medical schools and
academic medical centers," according to the organization's Web site.
If the medical profession, medical educational system, and industry do not
police themselves, lawmakers may step in and do it for them. In April, the
Massachusetts state Senate passed a bill to prohibit all gifts of any value to
health care providers from pharmaceutical and medical device companies. The
bill is waiting for approval by the state House of Representatives and the
governor. A month later, New York Gov. David Patterson (D) proposed
legislation to ban gifts and payments from drug companies to physicians and
other prescribers with values exceeding $50 a year. Minnesota's legislature
has already enacted a similar ban.
The AMSA assessment of conflict-of-interest policies is posted at<www.amsascorecard.org>."
Report of the AAMC Task Force on Industry Funding of Medical Education
to the AAMC Executive Council" is posted at<www.aamc.org/research/coi/start.htm>.▪