Health Care Marketing: The End of the Gift Era?

During the past several months, legislators seem to have discovered the world of health care marketing.

In an effort to control the influence that pharmaceutical and medical device makers might have on physicians and other health care professionals, a handful of states have either considered or already put legislation into the pipeline that would limit the value of gifts or honoraria they can accept.

Two states, Minnesota and Vermont, have mandatory physician gift reporting laws on the books. Minnesota physicians must report to a state agency any gift they receive with a value of more than $50. In Vermont, the limit is $25.

In Massachusetts, a bill that has already passed the state Senate would put the limit at zero. Finally, bills have been introduced in both the U.S. Senate and House of Representatives that would mandate federal limits.

Most, if not all, health care tradeshow managers say they already follow guidelines set by the American Medical Assn. when it comes to the gifts exhibitors might distribute to drum up traffic to their booths on a showfloor. The Pharma and AdvaMed codes in some cases are even stricter. What's more, many in the health care sector of the tradeshow industry say it is only common sense that a showfloor giveaway is not enough to influence a physician in what he or she might prescribe or recommend to a patient.

Still, as Andrew Niles, industry relations and exhibitions manager for the American Urological Assn., said of what could be a forthcoming era of greater regulation, “It might take the fun out of things. Medical shows are the most reserved of all tradeshows already.”

Kristine Rapp, vice president of global ethics and compliance for Hospira Inc., a pharmaceutical and medical device manufacturer and developer, said, “I'd like to reflect on how that sounds to other people.”

Rapp, an expert on health care regulatory issues who will speak at the Healthcare Convention & Exhibitors Assn. Annual Meeting & Exhibition June 21-24 in Salt Lake City, said it isn't just state and federal legislators who are interested in the issue. Professional organizations in the health care field and hospital systems also are drawing up their own guidelines that Rapp said “will drastically change the showfloor.”

“The arena of health care is under a microscope,” she added. “People are looking at how money can be spent more wisely.”

Health care shows and meetings, along with other forms of marketing for the industry, have long been highly regulated.

“The rules and regulations we put in place years ago were pretty strict to begin with,” said Tom Shimala, director of technical exhibit services for the Radiological Society of North America Assembly & Annual Meeting.

Shimala said that some time ago his show (at No. 33, the largest health care show on the 2008 Tradeshow Week 200) put a $1,000 limit on the size of raffle prizes.

“I won't name the other show, but I know of one that is still raffling off a car,” he added.

While Shimala said he is aware of the concerns about conflict of interest, at least part of his reason for the raffle limits was showfloor equity.

“I was fighting for the little guy,” he added, referring to smaller exhibitors who may not have the resources of the major pharmaceutical and medical device makers.

Shimala echoed the sentiments of other show managers contacted by TSW when he said, “We're very concerned about our industry and how we're perceived by the industry. That's why we're very conservative and cautious.”

The self-policing that Shimala and others say is already underway may not be enough.

“For most physicians, a $25 gift is not going to be enough of an incentive to jeopardize their standing,” said Niles, who manages the AUA Annual Meeting & Exhibition. “Still, a lot of this is a reaction to the concept of drug prices being very expensive.”

That, Rapp said, is why legislators at both the state and federal levels are getting into the act.

“This is all about making sure health care dollars are well-spent,” she added.

Besides the regulations in place in Minnesota and Vermont and the bills already introduced in Massachusetts and the U.S. Congress, measures also are being considered in Connecticut and California.

“I think this is a good thing,” Rapp said. “When you look at some of the sizable financial ties in the past between pharmaceutical companies and health care institutions, you start to wonder.”

“Are these regulations the wave of the future?” she asked rhetorically. “It's hard to say, but more and more legislators are starting to ask these same questions.”