A West Virginia state council trying to control rising prescription-drug costs is considering licensing and regulating pharmaceutical sales representatives.
At least 21 other states and Washington, D.C., have considered legislation or have bills pending to require marketing disclosures by drug companies, said Kevin Outterson, a West Virginia University law professor and member of the Pharmaceutical Cost Management Council.
"A lot of states are looking at this, and they're looking at it because they think that regulating the marketing of drugs will affect the money they pay," he told the council at a meeting Thursday.
In 2002, the pharmaceutical industry spent an estimated $22 billion on marketing, including about $5.3 billion on direct marketing to physicians and about $12 billion to provide free drug samples for doctors to pass on to patients.
By comparison, direct-to-consumer advertising came in at $2.6 billion.
Outterson proposed that the state license pharmaceutical sales reps, require them to report their spending, and make it illegal to use expensive gifts or other inducements to encourage doctors to prescribe particular drugs.
Peter Safir, a Washington lawyer who attended the meeting at the request of Pharmaceutical Research and Manufacturers of America, the national drug industry lobby, said voluntary standards the industry imposed in 2002 "did away with many practices the industry itself felt had gotten out of hand.
"Under the PhRMA code, a representative taking a physician out to play golf is prohibited," Safir added.
The voluntary code also prohibits gifts to doctors that are worth more than $100 and requires the gifts be educational or practice-related items, such as anatomical models or textbooks.
The code also bars the formerly common practice of drug companies paying for doctors to attend medical conferences.
Safir said he did not think drug companies would object if West Virginia put those guidelines into state law.
Outterson said licensing the sales reps simply makes sense.
"We license all sorts of things," he said. "We license people who cut hair. We know nothing about these people, whether they've been disciplined in other states or have a criminal record."