In Defense of the Free Pharma Lunch

Recent study results published in JAMA showed a correlation between drug company-sponsored meals and physician prescribing practices.

The unspoken implication is that this is somehow improper or unethical. However, I suspect most readers will find this pretty unimpressive. The only surprising thing is that it took 6 researchers to figure this out.

Of course, news about this study hit major networks within days. Reporters acted like they’d uncovered a virtual culinary conspiracy. Move over, Watergate; scientists have discovered a correlation between pizza and prescription writing.

Those of us who’ve been around the pharmacy block know this isn’t landmark research; it’s common sense. Social scientists have long spoken about the psychology of reciprocity, the instinctive desire to “give back” once a gift has been given or a favor has been done.

Besides, this is hardly the first time JAMA has ever touched this topic. I clearly remember the 2000 article titled, “Physicians and the Pharmaceutical Industry: Is a Gift Ever Just a Gift?”

We all agree that buying dinner for physicians may influence their prescribing. Some say it’s a subtle and socially acceptable form of brand-name bribery. Pundits may point their fingers and spew out pejorative pieces of punishment upon these prescribers, but I have one thing to say to them: stop making a mountain out of this molehill.

I stand up for the rights of pharmaceutical companies to buy lunches or host dinners that are educational in nature. Academics, reporters, and politicians who fear this practice is driving up the costs of health care need to calm down and think differently.

Here are 7 reasons to relax about the free pharma lunch:

1. Most health care providers work long hours and don’t have much availability in their day-to-day schedules. Many are on call nights, holidays, and weekends. In spite of this, they have to remain on the cutting edge of medical science, including knowledge about new drugs. Therefore, it’s simply efficient to combine learning opportunities with meals.

2. A health care provider’s time is extremely valuable. Every provider is needed at virtually all times. It’s all hands on deck every day to care for patients and save or improve lives. As such, every minute spent “working” is important and valuable. A relatively inexpensive meal in exchange for 15 to 20 minutes of time is a bargain.

3. The fact that prescribing frequency increases after engaging in lunch-and-learn sessions doesn’t mean that physicians wrote prescriptions out of guilt because they were given a free tuna fish sandwich, as they could afford their own lunch quite easily. The prescribing frequency could just as easily be tied to the education.

4. Providing a meal is a socially acceptable means for showing kindness and respect. If I want to thank you for your time, I might bake you a cake or cook you a casserole. You came over and fixed my computer? You’re getting a pizza. Sales representatives are responsible for educating prescribers in their territory through face-to-face meetings. A meal represents a tangible token of appreciation for their time.

5. Patients benefit when health care providers develop relationships with pharmaceutical companies. Many of these companies offer educational resources to patients and financial assistance to the uninsured or underinsured. But, getting these benefits to patients typically requires building relationships with providers. As a pharmacist, I can say I’m very grateful for some of the outstanding sales representatives I’ve gotten to know, because the services their companies offer are useful to my patients. Sometimes, these relationships have been built over a burger. Is that a crime?

6. Yes, it’s possible for incentives to go too far, but we’re talking about $18 to $20 meals, not lavish trips to the Swiss Alps.

7. Health care providers aren’t computers or machines. Learning takes time, and reminders about how a drug fits into the current recommended treatment regimen is appreciated. A drug representative gets to be an expert on a particular molecule, but we have to know all the molecules. So, spending a few moments with an expert on 1 specific drug helps reinforce best practices and treatment standards.

As a pharmacist, I’ve gotten to know many pharmaceutical representatives over a sandwich. We talk about health care, drugs, side effects, and how to help patients. Those conversations are valuable to me, and I don’t mind the sandwich.

Is this an unfair perk of the profession? I don’t know, but I have friends who teach at colleges and their children get to go to college tuition-free. Meanwhile, I get a sandwich, so I’m not sure what we’re getting all excited about.