Seattle-Based Clinic Begins Charging Visiting Pharmaceutical Representatives

A multispecialty clinic in Seattle, Wash., last week launched a "pay-per-view" policy for drug company representatives visiting the facility's physicians, the Seattle Times reports. The physician-owned Polyclinic, which serves about 100,000 patients, will charge fees ranging from $30 for a one-hour visit to $200 for eight hours. The payments do not guarantee physician contact, the Times reports. Polyclinic medical director Dr. Richard Clarfeld said that the new policy was implemented because the information drug representatives provide "has been outweighed by the disruption they cause and their promotion of expensive drugs, which undermines the clinic's effort to promote lower-cost alternatives" to its doctors. Polyclinic executive director Lloyd David said that the clinic is "just trying to cover the costs of watchdogging legions of drug-company salespeople." He added that by the end of the year, the clinic plans to establish a drug formulary and will "close its doors to all drug reps." The Polyclinic has hired a consultant and established a committee to create a "scientifically supported" drug list.

Causing Controversy
Some doctor groups and drug companies have raised concerns about the clinic's pay-per-view policy, saying that charging drug representatives could have a "chilling effect on the flow of free drug samples and educational programs" and could violate some ethical guidelines, the Times reports. Pharmaceutical Research and Manufacturers of America spokesperson Jeff Trewhitt said, "Physicians receive important information about new medicines and their characteristics, including potential side effects, from technically trained sales representatives." Dr. Frank Riddick, chair of the American Medical Association's ethics committee, which recently revised its policies on payments by drug representatives, said that doctors should not accept money, "directly or indirectly," to be educated by drug reps, "nor should they accept gifts." He added, "Either way you slice it, it's in violation of the existing rules on the interaction. Our decision was: Physicians shouldn't be paid to educate themselves, and if it's not education, then it's a gift" (Ostrom/Timmerman, Seattle Times, 6/6).