With the holiday crush nearing its end, PostScript would like to tip its hat (or pen) to the following parties whose bold efforts to help turn the tide against unfettered pharmaceutical marketing may have gone unnoticed in the waning days of 2007. 

UMass Memorial Medical Center – The academic medical center, which also comprises UMass Medical School, announced some of the most stringent conflict of interest policies governing physician-industry relationships in the country. The move follows Boston Medical Center-Boston University School of Medicine’s adoption of equally tough standards earlier this year.

The Prescription Project’s David Rothman called UMass’s policies “gold standard,” citing bans of company meals on and off campus, a requirement that drug samples be delivered to the hospital pharmacy rather than to physicians, and the direction of all industry funds for continuing medical education to the UMass Memorial Foundation as particularly “ahead of the curve.” In the interest of full disclosure and at the risk of sounding like there’s a little horn tooting going on here, the Project provided guidance and feedback to UMass as it developed its policies. But it takes more than a village to bring about such sweeping reforms – it takes strong institutional leadership, the willingness to change the culture of an institution, and the ability to balance the needs of faculty, clinicians and patients with the need to establish fair, effective conflict of interest standards. We hope that in the year ahead, many other academic medical centers will follow suit.

Representative Rosa DeLauro – The Connecticut congresswoman and chair of the subcommittee that funds the FDA added a major speed bump into a federal appropriations bill that effectively puts the brakes on funding for the FDA’s newly created Reagan-Udall Foundation. DeLauro cited concerns about potential conflicts of interest arising from Big Pharma’s funding of the Foundation, a so-called private, independent nonprofit organization created to “advance FDA’s mission to modernize medical, veterinary, food, food ingredient, and cosmetic product development, accelerate innovation, and enhance product safety.”In early December, she sent a pointed letter to FDA Commissioner Dr. Andrew von Eschenbach questioning the appointment of Dr. Tadataka Yamada to the Foundation board in the wake of a Senate Finance committee report that found Dr. Yamada, former chief of research for GlaxoSmithKline, had attempted to intimidate a scientist who raised red flags about the GSK’s blockbuster drug, Avandia. In that letter, DeLauro also made reference to a previous unanswered letter she sent to von Eschenbach concerning the specter of industry influence in the Reagan-Udall Foundation and suggesting that she might rescind funding. Apparently, she wasn’t kidding. Perhaps letter #2 went unanswered, as well… 

Dr. James Orlowski – According to a Dec. 27 profile in the St. Petersburg Times, Dr. Orlowski is the only Tampa Bay-area doctor listed on “No Free Lunch.” (www.nofreelunch.org).

In the article, Dr. Orlowski, Chief of Pediatrics at Tampa’s University Community Hospital and an ardent opponent of pharmaceutical marketing to docs, recounts his days as a struggling med student when plentiful drug company freebie were hard to resist. But Orlowski did. “There was no way I was going to let a drug company gift influence my prescribing,” he said.

Today, Orlowski teaches med students under his guidance to just say “no” to pharma reps and has persuaded the hospital to ban free lunches and sales rep interactions with doctors, students and nurses.

One of PostScript’s 2008 resolutions is to find more Dr. Orlowski’s out there.