Just Saying No to Drug Reps

When we launched PLoS Medicine in October 2004, the editors announced that we would “not to be part of the cycle of dependency that has formed between journals and the pharmaceutical industry.”

Medical journals, we argued, had allowed their interests to become aligned with those of the pharmaceutical industry by printing drug ads, publishing trials designed by drug companies' marketing departments, and making profits on reprints used as marketing tools. In contrast PLoS Medicine, we said, “will not accept advertisements for pharmaceutical products or medical devices. Our open-access license allows free distribution of articles, so PLoS cannot benefit from exclusive reprint sales. And we consider as the lowest priority for publication papers that are simply aimed at increasing a drug's market share without obvious benefit to patients.”

By putting a healthy distance between the journal and industry, we were joining a wider movement of physicians who are “just saying no” to the undue influence of drug companies upon medical practice and research. Some of the highest profile organizations in this movement are No Free Lunch (mission statement: “We are health care providers who believe that pharmaceutical promotion should not guide clinical practice”) and Pharmed Out, an independent, publicly funded project that “empowers physicians to identify and counter inappropriate pharmaceutical promotion practices.”

Pharmed Out has just created a “No Drug Reps Certificate” that you can download, print, and display in your office. The language and message are crystal clear:

“This office does not allow visits from pharmaceutical salespeople because we rely on scientific information, not marketing, to decide what treatment is best for you. This policy also means that we don't provide drug samples. "Free" drug samples cost you money. Samples are only available for the most expensive, most-promoted drugs, and are a tactic to get you to use drugs that may not be the best therapy for you.”

There’s space at the bottom for your signature and the date.

Adriane Fugh-Berman, Pharmed Out’s Principal Investigator, says that the certificate has been downloaded more than 1000 times in 10 days. “A physician in Australia,” she says “asked to substitute "taxpayers" for "you" on the certificate, as the government rather than consumers pays for drugs, so we added a version on the site for countries with a national health system.”

The new certificate has been discussed by some of the major pharma blogs (such as Pharmalot and Peter Rost's blog). “Unexpectedly,” says Adriane “several consumers have told us that they are bringing the certificate to their doctors, or, in one case, "flinging it under the door" of medical students.”