In what the NY Times calls “a growing movement among academic institutions,” Stanford University Medical Center will ban gifts — even small ones like pens — from pharma sales reps to physicians who work there, the NY Times reported today.

Excluded are the pens, prescription pads, and other inexpensive stuff that everybody sees all over their doc’s office, but also things that are less visible to the public — meals and ghost-written medical journal articles. Also excluded are free samples.

The article explains:

The move is part of a reaction against corporate influence on medicine at a time of growing concern over the safety and rising cost of drugs and medical devices. About 90 percent of the pharmaceutical industry’s $21 billion marketing budget is directed at physicians, according to an article by an influential group of doctors, scientists and lawyers in The Journal of the American Medical Association in January.

The JAMA article concluded, among other things, that even small gifts can affect prescribing behavior.

Pharma, unsurprisingly, takes strong exception to these policies:

Scott Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said the new policies were a “disservice to patients and physicians” because they keep doctors from interacting with sales representatives. “The company sales representatives, in our point of view, have a lot of useful information on drug products and how to use them, and how not to use them,” he said.

(Also see a previous blog about this, “Pharma Defends Use of Swag — Does Anyone Believe Them?”)

Fundamentally, Stanford’s decision, like a policy adopted by Yale and University of Pennsylvania, goes to a key component of the doctor-patient relationship: trust.

“We want to secure the public trust to value what happens in academic medicine,” Dr. Philip A. Pizzo, dean of the Stanford School of Medicine, said in an interview.

Despite the fact that:

the new policy would cost the medical center millions of dollars a year in industry support, like free meals that would now be largely prohibited. “Many faculty members and departments have become dependent on sponsored meals from industry in order to run seminars,” he said.

You may recall that AMSA, the American Medical Student Association, had sponsored a “pen amnesty” effort because, as one AMSA member put it:

I don’t think patients can trust us anymore, says Kristin Rising, a medical student at the University of California, San Francisco. By accepting gifts, we’re taking in biases that are going to affect patient care.

Drug companies don’t spend billions marketing to physicians for their health, or necessarily for our health. Pharma gifts — even free samples — are provided to get doctors to write prescriptions for newer, more costly drugs. Free samples get a patient on to a specific medicine, and a physician is likely less inclined to switch if it works — even if there are cheaper and equally safe and effective alternatives.