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Pharma freebies: a dwindling supply

Marilyn Eveleigh
Consultant Editor

Changes to the ABPI Code mean that promotional items, such as stationery and medical equipment for health professionals, will no longer be supplied in such abundance. Marilyn Eveleigh explains why ...

Nurses have long benefited from the hospitality, freebies and samples provided by their friendly pharmaceutical rep. I'll wager there is no surgery or health centre in the country that does not have sticky notes, mugs, clocks or pens exhibiting the name of a particular drug or pharmaceutical company. Long may it last, I hear you cheer.

However, in addition to the massive changes the NHS white paper has hailed, it seems these comforts on which we have come to depend are to be stopped. "Why have they become so mean?", I hear you groan. Simply, the Association of the British Pharmaceutical Industry (ABPI) Code has changed.

In the UK, pharmaceutical companies sign up to the ABPI Code of Practice for the advertising and promotion of prescribed medicines to health professionals. It covers everything from advertising, and how representatives conduct themselves, to hospitality and sponsorship, promotional meetings and exhibitions, the supply of samples and inducements to prescribe.

The Code ensures that pharmaceutical companies operate in a responsible, ethical and professional manner, and there are sanctions if breached. The Royal Pharmaceutical Society of Great Britain, the Royal College of Nursing (RCN), the British Medical Association (BMA) and the Medicines and Healthcare products Regulatory Agency (MHRA) are consulted in regular revisions of the Code.

Such a revision was agreed in November, which will be felt by nurses and others in healthcare when it is implemented in
May 2011. So what changes will we see?

  • Promotional aids for health professionals will no longer be provided; this includes textbooks and diaries, and clinical equipment such as surgical gloves, tissues, tongue depressors and desk items.
  • However, pens and pads (that cost less than £6) can be given to health professionals and appropriate administrative staff who attend scientific meetings, conferences and promotional meetings. Read-only DVDs and computer memory sticks with limited storage are allowed.
  • Items such as children's toys and puzzles may no longer be provided - but a storybook for young patients about a product or a disease can be, as it supports patients directly.
  • Promotional aids cannot bear a brand name but can have a company name, and will no longer be provided by representatives when calling upon health professionals.
  • Items can be supplied for health professionals to pass to patients as part of a formal patient support programme.
  • Patient support items such as placebo inhalers and peak flow meters can still be provided to patients under the supervision of a health professional.
  • Patient support items will not be given out at exhibition stands but examples can be displayed. Quizzes cannot be conducted from exhibition stands.

Medical and educational goodies cannot be provided to individuals for personal benefit - but can if they benefit a team. It will be interesting to see the impact on practice teams, and on the promotional and non-promotional reps we meet.

Working in isolation as so many do, community and primary care nurses have been highly dependent on reps for underpinning knowledge and training. This takes the form of casual updating of available therapies to sponsorship on independent, non-promotional training courses.  It has saved GP employers and the NHS significant expenditure.  Future support will carry constraints.

There is good news. Patient teaching aids, leaflets, self-management booklets and patient record card sheets are vital in supporting patients manage their own health. These will remain available as they are intended for patient use. Nurses would like to support the relevant charity with use of their materials but the economic reality is that drug companies supply the bulk.

Joint working with other pharma companies is encouraged in the Code and we may see some exciting projects involving a number of companies working together to support patient services. 

Realism is a necessary attribute in cash-strapped times. The Department of Health has issued good practice guidance on joint working between the NHS and pharmaceutical industry and other appropriate commercial organisations. The new GP commissioning consortia may well be interested in developing partnership working with the pharmaceutical industry to achieve measureable patient outcomes.

The pharmaceutical industry has long been a partner in healthcare, from laboratory research to workforce facilitation.  The complete Nursing in Practice package - with the journal, conferences and website free to all nurses - exists because of sponsorship and support from the pharmaceutical industry. OK, some readers might mourn the loss of a free mug, but watch this space - there may be better and more robust partnerships to come.