Look out, pharma marketers. California may turn off speaking fees and ban pharma gifts

A proposal pending in California would cut off the flow of speaking fees, travel and gifts to doctors, while limiting free meals to $250 per year. (Derek Gavey via Flickr)

Pharma reps may soon have to cancel any doctor dinners they have planned in California. A state-level bill would cut off most drugmaker payments to physicians, including speaking fees for that staple of pharma marketing, the slideshow over dinner.

Dinners themselves would have to be cheap, too: Per person, drugmakers could only spend $250 per year on free meals.

The California bill, approved by the state senate last week, would still allow physicians to be paid for conducting clinical trials, but it restricts a range of other payments and handouts, including free travel and entertainment, speaking and consulting fees, and, of course, meals.

Sen. Mike McGuire, who sponsored the bill, cited a University of California-San Francisco study showing that doctors who receive “industry gifts,” such as speaking fees, meals and travel, were two to three times more likely to prescribe branded meds rather than equivalent generics. Published in JAMA Internal Medicine last year, the study found that even inexpensive meals appeared to sway doctors’ prescribing habits. A previously published Harvard Medical School study drew similar conclusions.

“I’ll be the first to say that the vast majority of physicians and medical professionals put the needs of their patients first. There’s a reason why doctors answer the call to practice medicine—to help people in their time of need,” McGuire said in a statement announcing the passage of his bill. “But growing evidence reveals that financial relationships between some physicians and pharmaceutical companies confirm what has been suspected—financial incentives change minds.”

It’s not the first time state lawmakers have moved to curb pharma payments and gifts to doctors. Massachusetts has a similar law that, in its first iteration, not only curtailed speaking fees, travel, entertainment and other goodies, but more or less banned free meals. After high-profile pushback from tourism officials and restaurateurs—and grumbling from doctors who technically had to keep track of the free coffee they accepted at trade show booths—Massachusetts loosened the meal restrictions.

Vermont has its own doc-payment restrictions, as does Minnesota, which caps gifts and food at $50 per year and limits speaking fees to “reasonable” levels for “bonafide” educational purposes. Vermont’s law is so restrictive that lawmakers are trying to ease the limits to at least allow healthcare providers free sandwiches and coffee at medical conferences and CME events. Maine lawmakers are meanwhile working on a new bill modeled after the Minnesota law.

The California measure still has significant hurdles to clear. It’s now pending in the state assembly, and it’s opposed by industry groups, including PhRMA. Senators opposing the bill echoed industry contentions about similar restrictions: They could interfere with doctors’ ability to learn about new products—and with their sales, which fund new R&D.

“Successful products provide the funding for the research, for cures,” Sen. Ted Gaines argued (as quoted by the Times-Standard). “Why would we do anything to diminish the ability of pharma companies to be successful in providing these new products?”

California doctors racked up more than $1.4 billion in payments and gifts in 2014, according to ProPublica data, a figure larger than any other state’s total. Next in line was New York with $517 million.