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The End of the Junket?

Published on 10/05/07 at 12:13pm

Once considered a perk of the job by some doctors, trips to glamorous locations paid for by pharma companies are quickly becoming rarer and more sober events. Quietly, the days of the junket appear to be ending.

Until recently, first-class flights and accommodation for conferences in the UK and abroad, as well as copious quantities of food and drink, were available to scores of consultants and GPs, but these freebies are now drying up fast.

While the practice has genuinely helped doctors keep up-to-date with clinical advances, there is now a strong sense that too many doctors have been invited too indiscriminately, and with insufficient focus on education.

No official figures exist, but extensive research by Pharmafocus suggests that the number of doctors being sponsored to attend conferences has dropped by as much as 50% in the last 18 months.

Pharma companies and agencies say that the new ABPI Code of Practice, introduced in January 2006, has rapidly changed the nature of industry/medical relationships, with educational events now more truly focused on education than ever before.

Stung by sustained criticism of inappropriate influence and reports of sleazy schmoozing, the industry has now turned its back on the junket.

Dr Martin Goldman, senior medical advisor at Forest Laboratories, said: "When one goes to these meetings they tend to be lower key, with not as much money being spent - certainly the alcohol has ceased to flow. Wev'e been to one or two meetings where there's no alcohol at all, which is unusual."

The industry used to spend so heavily on luxury hotels that a number of five-star chains have toured the major pharma companies to win back the business they have lost, but to no avail. These days, the standard venue is a middle-of-the-road business hotel, rather than the most expensive restaurant or hotel in town, and the education on offer is more important than the vintage of wine.

Dr Des Spence, a Glasgow GP and spokesman for anti-hospitality group Nofreelunch, said: "In the past, each doctor in the practice and some of the nurses might be invited to one or two meetings a week and it's very much less now  maybe you get one or two a month.

"There has been a sense that some of the less obviously educational meetings have died a death  quite a lot of the kind of evening meetings in restaurants have fallen away. There are still larger meetings, but the hospitality-based ones have stopped it seems."

But Dr Spence says it may be still too early to announce the death of the junket.

"My understanding from colleagues is that the international junkets are still going on. I don't get invited to those sorts of things, but speaking to colleagues who do, there's quite a lot of wining and dining at the international conferences."

Pharma companies for their part are becoming more careful. "Quite frankly, it's got to the point now that we know that doctors will go to every company they can to get sponsorship and where you spend your money has become a major issue," said Dr Goldman.

Where it once would have sponsored doctors to attend overseas conferences, Forest has instead decided to supply materials to improve patient care, in particular specialist nebulisers for cystic fibrosis that wouldn't otherwise be funded in the NHS. Over at Pfizer, each healthcare professional sponsored now has to sign an agreement that states the company does not expect anything in return for its donation and support is on a 'first-come, first-served' basis.

Heather Simmonds of the industry's self-regulation body, the PMCPA,says the UK industry has worked hard to improve its reputation and sees the changes as a sign of its commitment to self-regulation.

She adds that some doctors have complained about the new culture, but that many healthcare professionals have also been very supportive of its aims.

Despite this progress, some would prefer pharma to stay out of medical education altogether. Dr Spense said: "I don't think pharma companies should be involved in medical education, because the people who set the agenda tend to set the messages and the industry has a strong vested interest in education as a way of marketing. But it's about being pragmatic about these things and if things have improved, then that's good."

Many in the industry believe the changes will not only improve pharma's image, but that they have already raised standards in its med ed programmes.



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