19.1 Companies must not provide hospitality to members of the health professions and appropriate administrative staff except in association with scientific meetings, promotional meetings, scientific congresses and other such meetings, and training. Meetings must be held in appropriate venues conducive to the main purpose of the event. Hospitality must be strictly limited to the main purpose of the event and must be secondary to the purpose of the meeting ie subsistence only. The level of subsistence offered must be appropriate and not out of proportion to the occasion. The costs involved must not exceed that level which the recipients would normally adopt when paying for themselves. It must not extend beyond members of the health professions or appropriate administrative staff.
19.2 Payments may not be made to doctors or groups of doctors or to other prescribers, either directly or indirectly, for rental for rooms to be used for meetings.
19.3 When meetings are sponsored by pharmaceutical companies, that fact must be disclosed in all of the papers relating to the meetings and in any published proceedings. The declaration of sponsorship must be sufficiently prominent to ensure that readers are aware of it at the outset.
19.4 Pharmaceutical companies must make publicly available financial details of sponsorship of UK health professionals and appropriate administrative staff in relation to attendance at meetings organised by third parties. Sponsorship in this context includes registration fees, costs of accommodation (both inside and outside the UK) and travel outside the UK.
The provision of hospitality is limited to refreshments/subsistence (meals and drinks), accommodation, genuine registration fees and the payment of reasonable travelcosts which a company may provide to sponsor a delegate to attend a meeting. The payment of travel expenses and the like for persons accompanying the delegate is not permitted. Funding must not be offered or provided to compensate merely for the time spent by health professionals in attending meetings. The payment of reasonable honoraria and reimbursement of out of pocket expenses, including travel, for speakers, advisory board members and the providers of other professional services, is permissible. The arrangements for meetings must comply with Clause 19.1 with regard to hospitality and venues.
Companies should only offer or provide economy air travel to delegates sponsored to attend meetings. Delegates may of course organise and pay at their own expense the genuine difference between economy travel and business class or first class.
Pharmaceutical companies may appropriately hold or sponsor a wide range of meetings. These range from small lunchtime audio-visual presentations in a group practice, hospital meetings and meetings at postgraduate education centres, advisory board meetings, visits to research and manufacturing facilites, planning, training and investigator meetings for clinical trials and non-interventional studies, launch meetings for new products, management training courses, patient support group meetings and satellite symposia through to large international meetings organised by independent bodies with sponsorship from pharmaceutical companies.
With any meeting, certain basic principles apply:
Administrative staff may be invited to meetings where appropriate. For example, receptionists might be invited to a meeting in a general practice when the subject matter related to practice administration.
A useful criterion in determining whether the arrangements for any meeting are acceptable is to apply the question ‘would you and your company be willing to have these arrangements generally known?’ The impression that is created by the arrangements for any meeting must always be kept in mind.
Meetings organised for groups of doctors, other health professionals and/or for administrative staff which are wholly or mainly of a social or sporting nature are unacceptable.
Meetings organised by pharmaceutical companies which involve UK health professionals at venues outside the UK are not necessarily unacceptable. There have, however, to be valid and cogent reasons for holding meetings at such venues. These are that most of the invitees are from outside the UK and, given their countries of origin, it makes greater logistical sense to hold the meeting outside the UK or, given the location of the relevant resource or expertise that is the object or subject matter of the meeting, it makes greater logistical sense to hold the meeting outside the UK. As with meetings held in the UK, in determining whether such a meeting is acceptable or not, consideration must also be given to the educational programme, overall cost, facilities offered by the venue, nature of the audience, subsistence provided and the like. As with any meeting it should be the programme that attracts delegates and not the associated hospitality or venue.
Promotional material which is displayed or provided at international meetings held outside the UK may, unless prohibited or otherwise regulated by local laws and regulations, refer to medicines or their indications which are not registered
in the country where the event takes place, or which are registered under different conditions, so long as any such material is accompanied by a suitable statement indicating countries where the product is registered and making clear that the product is not registered locally. Any such promotional material which refers to the prescribing information authorized in a country or countries where the medicine is registered must be accompanied by an explanatory statement indicating that registration conditions differ internationally.
The requirements relating to international meetings held in the UK are set out in the supplementary information to Clause 3.
The requirements of the Code do not apply to the provision of hospitality other than to that referred to in Clauses 19.1 and 23.2 and the supplementary information to Clauses 20 and 22.2.
Companies should remind their affiliates outside the UK that the ABPI Code of Practice must be complied with if UK health professionals attend meetings which they organise regardless of whether such meetings occur in the UK or abroad.
Pharmaceutical companies must ensure that all meetings which are planned are checked to see that they comply with the Code. Companies must have a written document that sets out their policies on meetings and hospitality and the associated allowable expenditure. In addition, meetings which involve travel outside the UK must be formally certified as set out in Clause 14.2.
The General Medical Council is the regulatory body for doctors and is responsible for giving guidance on standards of professional conduct and on medical ethics. In its guidance, the Council advises doctors that ‘You must act in your patients’ best interests when making referrals and when providing or arranging treatment or care. You must not ask for or accept any inducement, gift or hospitality which may affect or be seen to affect the way you prescribe for, treat or refer patients’.
The General Pharmaceutical Council is the regulatory body for pharmacists and pharmacy technicians. The Council’s Standards of conduct, ethics and performance state ‘Do not ask for or accept gifts, rewards or hospitality that may affect, or be seen to affect, your professional judgement’.
The Code of the Nursing & Midwifery Council, Standards of conduct, performance and ethics for nurses and midwives, states ‘You must not abuse your privileged position for your own ends’ and ‘You must ensure that your professional judgement is not influenced by any commercial considerations’.
The provisions of this and all other relevant clauses in the Code apply equally to meetings and courses organised or sponsored by pharmaceutical companies which are continuing professional development (CPD) approved, such as postgraduate education allowance (PGEA) approved meetings and courses. The fact that a meeting or course has CPD approval does not mean that the arrangements are automatically acceptable under the Code. The relevant provisions of the Code and, in particular, those relating to hospitality, must be observed.
This provision does not preclude the payment of room rental to postgraduate medical centres and the like.
Payment of room rental to doctors or groups of doctors or to other prescribers is not permissible even if such payment is made to equipment funds or patients’ comforts funds and the like or to charities or companies.
Attention is drawn to Clause 9.10 which requires that all material relating to medicines and their uses, whether promotional or not, which is sponsored by a pharmaceutical company must clearly indicate that it has been sponsored by
It should be noted that where companies are involved in the sponsorship and/or distribution of reports on meetings or symposia etc, these reports may constitute promotional material and thus be fully subject to the requirements of the Code.
Meetings at which attendance is sponsored by companies must comply with Clause 19.1. The information required by Clause 19.4 must be made publicly available in respect of sponsorship for attendance at meetings held in 2012 and each calendar year thereafter. Disclosure must be in the calendar year following that in which the payments were made and the information must be made public within three calendar months of the end of the company’s financial year.
The information which must be disclosed is the total amount paid in a calendar year in respect of all recipients and the total number of recipients. The total number of attendances at meetings sponsored in the year must also be given. The names of the recipients need not be disclosed.
Registration fees have to be included where the sponsorship of UK health professionals and appropriate administrative staff to attend meetings is paid by overseas affiliates, head offices in the UK or overseas and UK based European offices.
All reasonable steps should be taken by local operating companies to disclose their best estimates of the amounts for accommodation costs (both inside and outside the UK) and travel outside the UK for UK health professionals and appropriate administrative staff paid by overseas affiliates, head offices in the UK or overseas and UK based European offices.
