PharmaDesign offers pill cases that can be used to provide patient information as well as help with compliance.

Four years after the Washington-based Pharmaceutical Research and Manufacturers of America issued its Code on Interactions With Healthcare Professionals, drug companies are in a seemingly endless search for leave-behind items that resonate with physicians professionally while allowing sales reps to send a positive marketing message.

Not only can a well-thought-out, practical gift help physicians perform their jobs more effectively, which translates into improved patient care and satisfaction, but it can also help the rep who presents it leave a favorable impression. And with roughly two-thirds of patients walking away from an appointment with a prescription, that reminder item could continue to benefit pharmaceutical companies long after the rep-physician interaction takes place.

"Pharmaceutical reps have somewhere between 30 seconds and two minutes to spend with a physician," says Joan Charbonneau, president and CEO of Promotions Unlimited Inc., Basking Ridge, NJ. "With such a small window of time and so much competition from other drug companies, it's important that what is being left behind offers real value from a medical relevance standpoint and [imparts] an effective message."

A tough audience

AM/PM pill cases provide a visual reminder of when patients should take their medications.

Despite the stricter guidelines on promotional gifts, a growing number of physicians are becoming increasingly aware of the gifts given by drug reps. Although the PhRMA guidelines do not prohibit the distribution of low-cost, benign reminder items — such as branded pens, coffee mugs, clipboards and paper tablets — some prescribers aren't eager to accept these and other miscellaneous marketing items that can clutter an office.

As one Phoenix-based nurse practitioner, who routinely is inundated with pen- and mug-wielding detailers, points out, "You don't find many physicians or [nurse practitioners] saying to a drug rep that they need another pen. The gesture may be appreciated, but this type of [item] is not really of value, especially when you have a drawer overflowing with them."

Some prescribers, however, view even the gesture itself less than favorably. Aside from a growing number of no-see physicians, drug reps are facing new challenges from prominent organizations, such as the American Medical Student Association, that aim to halt all interactions between pharmaceutical representatives and physicians. In 2002, AMSA, the first (and, so far, only) medical organization to ban all pharmaceutical marketing in its publications and events, developed the PharmFree Campaign, which encourages medical students to shun any gifts from drug companies. Since then, AMSA's initiatives have ignited interest from other healthcare organizations, including the AARP, which joined forces with AMSA in August to call on the New York State Senate to pass a strict drug gift disclosure bill that would make information on gifts to doctors available to the public. Although the bill wasn't approved, some fear the unwavering commitment of many next-generation doctors to keep drug reps out of physicians' offices could spell trouble for pharmaceutical companies in the future.

Seven- to 14-day pill cases provide versatility for doctors seeking to keep their patients compliant.

Scott Lassman, PhRMA's senior assistant general counsel, has expressed concern about such hard-hitting initiatives. Although he says there's nothing wrong with policies that further promote the importance of providing medically relevant gifts and useful drug information, Lassman stresses that some efforts are "Draconian and overboard" and could ultimately cut down on valuable interactions and the dissemination of safe prescribing and dosing information.