ACCP releases position paper on ethical interactions

This is just one of eight cases that were presented at the annual meeting of the American College of Clinical Pharmacy last month in Denver as examples of professional situations routinely encountered by pharmacists that are potentially ethically inappropriate. At a town hall meeting, ACCP's Public and Professional Affairs Committee presented its new position paper, Pharmacists and Industry: Guidelines for Ethical Interactions, an update to the original paper developed in 1993.

According to committee co-chair, Randy Hatton, Pharm.D., FCCP, BCPS, "We had the opportunity to include supporting information from the new PhRMA [Pharmaceutical Research & Manufacturers of America] code, the Office of Inspector General's [OIG] compliance program for pharmacy and manufacturers, and the new standards of support for CME [continuing medical education]-which is applicable to continuing education for pharmacists."

The position paper includes 10 guidelines that highlight the appropriateness of pharmacists' engagement in activities ranging from accepting gifts, performing educational programs, doing research, as well as acceptable behavior for R.Ph.s who participate on formulary committees, institutional review boards, or are involved in developing clinical practice guidelines. The position statement also emphasizes that the pharmacist's primary concern should be patient welfare, as well as maintaining the confidentiality of the patient and the prescriber for all industry interactions.

"What we're recommending here is that you review this position statement, develop your own set of guidelines and principles and, as situations arise, modify them and encourage dialogue among your colleagues so that we can all come to a professional and ethical framework on which to function," Hatton explained.

One of the biggest changes from the old guidelines is the issue of conflict of interest and disclosure. "What has been recognized since that time is that disclosure by itself is insufficient," Hatton said.

Experts in their field

The new paper also speaks to pharmacists who function as experts. Hatton said that pharmacists who serve on formulary committees and guideline panels and have conflicts of interest should not participate in a final vote that leads to a decision.

As part of the case presentations, ACCP included findings from a survey of 9,000 of its members. In early October, ACCP e-mailed the eight cases to respondents, allowing them five days to read the cases and decide how they would handle the situation. Of those e-mailed, 795 were returned, an almost 9% response rate. Appropriate answers for each case, based on the new position statement, were then presented to the audience.

In addition to using the new guidelines, Hatton suggested that pharmacists spend some time assessing their own behavior. "Ask yourself, What would my patients and peers think?" he said. "It's a serious question. How would what I'm doing be perceived if it appeared on the front page of a newspaper? or Would it hold up in an interview on '60 Minutes'?" he asked rhetorically. "One of the most important tests is not what you think, but what others think."

The new ACCP position statement can be accessed on-line at http://www.accp.com/position/Guidelines_for_Ethical_Interactions_DRAFT.pdf.