Despite the fact that only two medical schools ban sales representatives from campus, the majority of U.S. medical schools have implemented strong conflict-of-interest policies this year, according to the 2011-2012 American Medical Student Association (AMSA) PharmFree Scorecard. Released today, the Scorecard finds that 102 of 152 medical schools (67%) now receive a grade of A or B for their policies governing pharmaceutical industry interaction with medical school faculty and students, compared with 79 last year.
Using letter grades to assess schools’ performance in eleven potential areas of conflict, the AMSA PharmFree Scorecard (www.amsascorecard.org) offers a comprehensive look at the current and changing landscape of conflict-of-interest policies across American medical education, as well as more in-depth assessment of individual policies that govern industry interaction. Now in its fifth year, the Scorecard analyzes gifts and meals from industry to doctors, paid promotional speaking for industry, acceptance of free drug samples, interaction with sales representatives and industry-funded education. The participation rate was 98% of all eligible medical institutions.
Of the 152 U.S. medical schools, 28 receive As (18%), 74 Bs (49%), 15 Cs (10%), 13 Ds (9%) and 9 Fs (6%). Thirteen respondents received a grade of “In Process” because their policies are currently under review or revision.
For the fifth consecutive year, access of sales representatives remains a challenging area. Only two schools – University of South Dakota Sanford School of Medicine and Florida State University College of Medicine – completely ban sales representatives from campus, giving them a perfect score in that domain. “Industry sales representatives are employed to increase the sales of their company’s drugs. Permitting their access to medical staff is not in the interests of patients or staff,” says Lee Shapley, AMSA PharmFree Scorecard director.
Another challenge continues to be distribution of free pharmaceutical samples. Fifty-four schools have no significant policy restricting the distribution and use of samples though it has been shown that samples lead physicians to prescribe drugs that differ from their preferred drug choice, reducing their prescribing of unadvertised drugs in favor of advertised drugs. The U.S. pharmaceutical industry distributes some $18 billion per year in drug samples.
Only 19 schools (13%) have model policy in terms of disclosure, requiring personnel to disclose past and present financial ties with industry (e.g., consulting and speaking agreements, research grants) on a publicly-available website and disclosing these relationships to patients. “This is a particularly interesting statistic because the upcoming implementation of the Physician Payments Sunshine Act will require public disclosure by industry of all payments and gifts so the public may learn of conflicts of interest before the schools,” continues Shapley.
Highlights of the survey include:
• Harvard Medical School received an ‘A’ this year. In 2008, Harvard had no policies and received an ‘F’ on the Scorecard. Due in large part to student activism over the past four years, the school now has one of the strongest policies in the country that includes a ban on speaker bureaus in addition to a strong gift, disclosure and samples policy.
• Four schools significantly improved their scores from ‘F’s to ‘B’s. These schools are: University of Texas Health Science Center at Houston, University of South Carolina, Howard University and Morehouse School of Medicine.
• All eight of the Texas medical schools scored at least a B. The University of Texas Medical Branch at Galveston, however, remains the lone A in the Lone Star state.
• Approximately one quarter of U.S. medical schools improved their conflict-of-interest policies since the release of the 2010 PharmFree Scorecard.
• More than two-thirds of medical schools now have grades of A or B (102 schools).
• Schools with model policies on speaking arrangements have grown tremendously; 17 schools ban or severely restricting participation in speaker bureaus.
Check out your school's grade at http://www.amsascorecard.org/.