The age of drug company trinkets officially ended this month. The age of drug company junkets still is going strong, though.
Voluntary marketing guidelines that went into effect with the new year ban drug companies from showering doctors with trinkets —  note pads, Post-It Notes, coffee mugs and other doo-dads emblazoned with drug brands and logos. About 40 pharmaceutical companies have signed on.
The new guidelines also ban some more expensive give-aways, such as free meals in pricey restaurants, to reward doctors for prescribing brand-name drugs,
The idea is to remove the NASCAR- like aura of sponsorship that permeates many doctors’ offices and, ultimately, to reverse the perception that drug promotions influence physicians’ prescribing habits. While free pens or Post-It Notes are no big deal, the cumulative value of the give-aways, which The New York Times reports total $1 billion, is substantial.

Gaping loopholes remain. The new rules still allow drug firms to pay big fees to physician “consultants,” some of whom do little more than lend their names and reputations to promotional material or make speeches promoting a particular product.
Companies still can pay to send doctors and their families to “educational conferences” at lavish resorts, where — after brief seminars — they are free to play golf or relax on the beach. And the firms apparently still can furnish expensive tickets to sporting events to favored physicians.
Physician groups acknowledge that such perks create at least the appearance of a conflict of interest. Just as legislators claim gifts and contributions from lobbyists don’t influence their votes, many doctors say the drug company gifts don’t influence their prescribing patterns.

The reality is that drug companies are not stupid. They track their promotional efforts with great care. They wouldn’t spend $1 billion a year on promotional gew-gaws, and billions more on physician marketing, if they didn’t earn a return on that investment.
The new voluntary guidelines are a modest improvement over the status quo. But history shows that voluntary disclosure requirements have not been effective in policing financial conflicts.
Last week, the prestigious New England Journal of Medicine revised its procedures for disclosing financial conflicts after it was revealed that a major study it published was funded by a company that benefitted from the results.
Last June, a congressional investigation disclosed that prominent child psychiatrists failed to disclose millions in payments from drug makers who benefited from their research.

The industry’s voluntary guidelines come as Congress is considering a mandatory disclosure law that would establish a national registry of drug company payments to physicians. Congress should move forward with that law, called the Physician Payments Sunshine Act.
Doctors are only human, prey to the same temptations as everyone else. It’s crucial that decisions about drugs and medical devices be based on the best available science, not the best available rewards.