Monday, October 12, 2009

Hands off the food, MN doctors! 

I saw this picture yesterday on Business Insider and wondered, what is it that Minnesota does differently that forces a drug manufacturer to write a sign saying "hands off the food, Minnesota doctors!" Here's your answer:

Two years after Minnesota officials forbade drug makers to give doctors more than $50 worth of food or other gifts per year, drug company sales representatives there are having a far harder time marketing to doctors. The rule change was small and almost accidental � a state official decided to interpret a 1993 law differently from his predecessor. But the effect on drug makers has been profound.

The year after the change, the number of visits that Minnesota primary care doctors accepted from drug sales representatives decreased at about twice the rate of the decline reported by primary care doctors nationwide, according to a survey by ImpactRx, a New Jersey firm that tracks pharmaceutical marketing. A growing number of Minnesota hospitals and clinics have banned routine visits from them.

�We have an extended hallway, and the sales reps sit there now without anything except maybe Styrofoam cups filled with M&Ms. The 30 pizzas are gone,� said Dr. Michael Severson, a pediatrician in Brainerd, Minn. �It�s made the doctors think about whether to ban them.�

A 1997 study found that medical students saw gift-bearing drug sales representatives as helpful while viewing with suspicion those without gifts. This experiment is now being played out statewide in Minnesota.

Leslie Pott, a spokeswoman for AstraZeneca, said the company provided �modest meals� to doctors because �given a physician�s demanding clinical schedule, the most efficient time for doctors and medical staff to meet with representatives is often during lunch hour.�

... Minnesota also requires drug makers to report all consulting payments made to doctors. Maine, Vermont and West Virginia have passed similar registry requirements, at least a dozen other states are considering them and Congress is considering a national one.
It's that last paragraph that tells the tale. If a MN doctor picked up a food item they'd have to report it. Rather than screen who eats what, they post this sign. It's a transactions cost story that inter alia Oliver Williamson might have told. Most remarkable -- this isn't an explicit law, it's just a state official's interpretation of the law. But we're "vile and stupid" to worry about increasing regulation of health care, right Prof. Krugman?

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