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ASTRA TRAVEL SUBSIDIES FOR FOSCAVIR INVESTIGATORS QUESTIONED

Executive Summary

ASTRA TRAVEL SUBSIDIES FOR FOSCAVIR INVESTIGATORS QUESTIONED in a letter to the Pharmaceutical Manufacturers Association by ex- Abbott public affairs executive David Jones. On April 23, Jones forwarded a copy of a March 25 letter from Astra to an unidentified doctor offering to "sponsor key researchers and clinicians to attend the Seventh International Conference on AIDS in Florence, Italy" in mid-June. Maintaining that Astra's offer represented a "violation of Article VIII, No. 4 of the Code of Pharmaceutical Marketing Practices," Jones requested that the association inform him "of the disposition of this matter." Jones, a central witness at the promotion and marketing hearings conducted by Sen. Kennedy (D- Mass.) last December, apparently sent the Astra offer to PMA as a test of the association's procedures for assuring adherence to the code. Jones started his career in the pharmaceutical industry with the trade association. The allegation that Astra violated the code is the first to be forwarded to PMA since the association adopted new ethics guidelines last December. PMA says it is pursuing the complaint in accordance with a compliance plan laid out by association president Gerald Mossinghoff in a Jan. 24 letter to Sen. Kennedy. Under the Jan. 24 plan, all "allegations" of code violations referred to PMA will "be immediately forwarded to senior management of the involved PMA member." Once the company has been notified, it becomes the individual member company's responsibility to review the questioned practice. PMA informed Astra of the Jones letter on May 8. Astra says that the limited number of physicians that it offered to send to the Florence meeting were researchers who have worked on the development of Foscavir (foscarnet). About six dozen doctors reportedly received the March 25 letter offering sponsorship. Astra's offer included a "round-trip coach airline ticket"; a "five-night stay at the five-star Villa Cora Hotel in Florence, Italy"; and free "travel arrangements" guaranteeing the doctors' "depart[ure from] the U.S. on Saturday, June 15, with arrival in Florence on Sunday, June 16 and departure from Florence on Friday, June 21." Under American Medical Association guidelines, adopted by PMA, it is considered unethical for physicians to accept "subsidies to pay for the costs of travel, lodging or other expenses incurred by physicians and their guests while attending medical education meetings, whether or not they are accredited continuing medical education courses." The AMA does not play a direct role in the monitoring of programs and promotions sponsored by drug companies. It exerts its influence indirectly through attention to physician conduct. Under the guidelines, an AMA spokesperson explained, physicians are not supposed to be receiving subsidies or having their travel expenses paid unless they are an "official presenter" at a symposium or educational event. A paid trip to a meeting by doctors not making presentations would "prima facie [fall] outside of the guidelines," the AMA spokesperson declared. To clarify and strengthen its position on acceptable educational programs and promotions, the AMA announced recently that it has begun formulating more detailed guidelines. The revised guidelines could be ready for adoption by the end of 1991 (see related story, T&G-1).
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