Pharmaceutical firms' generosity and physicians: legal aspects in Belgium

In this article we will examine the relation between physicians and (representatives of) the pharmaceutical industry. More in particular we want to discuss the appropriateness of some of the gifts that are given to physicians by companies in the pharmaceutical (and medical equipment) industry, since there has been growing concern about the potential negative consequences of these so-called 'gift-giving practices'. Although the relation between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavourable public perceptions, over-consumption and misuse of public money. First of all, a concise factual summary of the different types of gift-giving will be given, since not every gift can automatically be considered as inappropriate: depending on the extent to which the gift serves a function beneficial to patient care and on whether the same benefits can be realised through less costly promotional activities, gifts can be appropriate. In connection with that remark, we will next outline the positive and negative impact pharmaceutical promotion has on patient welfare, according to advocates as well as opponents of 'gift-giving'. We will not take position in the discussion whether 'gift-giving' is appropriate or not. This paper focuses on the position the (Belgian) legislator, following a European Directive of 1992, takes in this controversy. For the answer to that question the following documents are of crucial importance: the Belgian Law on Medicinal Products of 25 March 1964, the European Council Directive 92/28/EEC of 31 March 1992 on the advertising of medicinal products for human use and the Belgian Crown Order of 7 April 1995 on the advertising of medicinal products for human use. To round up, we will examine how the principles laid down in these documents are being interpreted in the Belgian case-law.