While only four 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 2013 American Medical Student Association (AMSA) PharmFree Scorecard. Released today, the Scorecard finds that 115 of 158 medical schools (73%) now receive a grade of A or B for their policies governing pharmaceutical industry interaction with medical school faculty and students, compared with 102 last year.
Find your school's grade here: www.amsascorecard.org.
Using letter grades to assess schools’ performance in eleven potential areas of conflict, the AMSA PharmFree Scorecard 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 sixth 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 158 U.S. medical schools, 40 receive As (25%), 75 Bs (47%), 13 Cs (8%), 13 Ds (8%) and 14 Fs (9%). Four respondents received a grade of “In Process” because their policies are currently under review or revision. For the sixth consecutive year, access of sales representatives remains a challenging area. Only four schools – University of South Dakota Sanford School of Medicine, Florida State University College of Medicine, Stony Brook University School of Medicine, and the Commonwealth Medical College – completely ban sales representatives from campus, giving them a perfect score in that domain.
Highlights of the survey include:
• Only 41 schools (26%) 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.
• 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. All three of the Maryland medical schools scored at least a B, with both Johns Hopkins and University of Maryland Schools of Medicine receiving an A.
• More than 70 percent of medical schools now have grades of A or B (115 schools).
• Schools with model policies on speaking arrangements have grown tremendously; 44 schools ban or severely restrict participation in speaker bureaus.
Public pressure to disclose conflict of interests is highlighted by the recent finalization of regulations governing implementation of the transparency reports as part of the Physician Payment Sunshine Act under the Affordable Care Act. The legislation requires certain manufacturers of pharmaceuticals and medical devices to report to the Centers for Medicare and Medicaid Services their financial ties to physicians and teaching hospitals.
AMSA and Pew were also charged through a grant from the Oregon State Attorney General’s office to update the AMSA PharmFree Scorecard and expand it to 400 teaching hospitals. Alongside Dr. Joseph Ross of Yale Medical School who served as a Methodology Consultant, AMSA and Pew developed the new AMSA PharmFree Scorecard set for release in 2014. There will be two versions of the new Scorecard - one for medical schools and another for teaching hospitals. The number of domains for the Scorecard has also expanded with 16 domains common to both versions and 2 additional domains for “Samples” and “Purchasing and Formulary Committees” specific to the teaching hospital version.
In the coming year, the AMSA PharmFree Scorecard will undergo a major revision in its methodology in an effort to guarantee it remains a relevant and state-of-the art tool for evaluating conflict of interest issues at medical schools. Revisions will include a new formula for assessing academic medical centers as well as revisions in our framework for grading schools. These changes will help to ensure that the Scorecard can continue to push schools to emphasize clinical education and medical care above all other interests, particularly those that could distract from the provision of evidence-based and patient-centered care.