Paying Minnesota physicians to participate in marketing surveys is no longer considered illegal, but tell that to pharmaceutical and medical device companies. A year after the state's Board of Pharmacy clarified the legality of remunerating doctors to gain their input on surveys, local agencies have yet to see a major uptick in business.
“We've seen a little bit [of business] starting to come back,” said Denice Duncan-Foldery, president of Minneapolis Fieldwork, which tests prototypes of pharma products and medical devices in its facility. “It's either a gap in education or just that large pharma company policy changes take a great deal of time. I'm not sure which, but we are still receiving questions from folks about whether or not it's kosher to do research in the Twin Cities, or receiving bid requests from our national office which still require Minnesota being left out of the bid.”
A clarification issued by the pharmacy board's executive director in February 2010 ought to have pre-empted this. Cody Wiberg told MM&M
that it was never the board's intention to prohibit payments to doctors in connection with survey work. New language went up on the board's website designed to make that clear. But a year later, despite the explanation, there remains a chill on pharma-supported field work in the state.
“It's incumbent upon us to really reach out to the device and pharmaceutical companies to let them know that that has opened up again, because the news doesn't seem to have reached them,” said Rosemary Sundin, president of Minneapolis-based Orman Guidance Research, a 35-year-old full-service agency. “I've only bid on two projects this year that have had anything to do with physicians, and that used to be a good 20% of our business, so it definitely did hurt us.”
Around 1996, Minnesota became what some describe as a fly-over state for market research. Gifts to physicians over $50 were outlawed under a 1993 statute. Due to the provision's wording, industry feared that survey payments would violate the law, even though manufacturers hire a vendor to carry it out and in most cases, the supplier is blinded to the sponsor.
“The speed at which manufacturers return to a place like Minnesota depends on the speed at which their legal departments decide the coast is clear,” said Bill Little, government affairs committee chair for the Pharmaceutical Marketing Research Group. He was part of a group that lobbied for the clarification. Yet, “Minnesota is really an important state from a medical and treatment perspective.”
Indeed, Medtronic makes its home there, as does one of the nation's top-ranked hospitals, the Mayo Clinic. That's why market researchers want to tap into the resident feelings, thoughts and attitudes.
“I'd like the voices of the Minnesota doctors to get back out there,” said Duncan-Foldery. “We're doing our best to educate folks.” This entails circulating articles showing that fear of punishment is no longer an issue. “Slowly but surely it's coming back; not as quickly as I would like.”
But Sundin is not optimistic that the impact of what ended up being a misinterpretation of Minnesota law can ever be reversed. “There are a couple of factors at work. It's not just that it was once considered illegal to remunerate a physician. There's been an increasing reluctance on the part of physicians themselves,” she said.
Why their reluctance to participate? “You've got a double whammy between [clinicians who say,] ‘it's not legal for me to take remuneration' and ‘the $300 is not worth my time because I'm going to go sit in a room and talk about some fluffy communication piece that is really going to drive the patient into the doctor's office to say, ‘I need this pill,'” Sundin said.
When pitching new physician projects, Sundin insists on a strong communication piece that helps doctors understand why their participation is important. Clients must understand that medical community participation hinges on “their identifying with an outcome and that by participating they impact that outcome,” she said. “If we just say things like, ‘We're trying to develop a communication piece,' that's probably going to have less of an impact. But if we say we're trying to predict patient outcomes [that may stroke a chord].”