Code of Marketing Practices

Marketing Practices Review Committee

Report on Code Infractions #43 - August 1, 2001 to October 30, 2001

1. Company and Issue: AstraZeneca Canada Inc. Event entitled “Moving Mountains - Oxeze PRN Launch Meeting,” Grey Rocks Resort and Convention Centre, Mont Tremblant, Quebec, April 6 - 8, 2001.

Discussion: The objectives of the program, as outlined by the company, were the following: “Hear and discuss the recent changes to the Canadian Clinical Treatment Guidelines for Asthma; provide an update on the current management strategies associated with the new guideline changes; discuss recent changes to the Formoteral CPS and its implications; and apply knowledge of new asthma guidelines by actively participating in actual case based scenarios.” The flyer pertaining to the event referred to an “educational program offer(ing) primary care physicians the opportunity to interact with a respiratory specialist to discuss new approaches in the treatment of asthma…” and it contained the following statement: “This event has been supported by an unrestricted educational grant from AstraZeneca.” Information concerning registration requirements were as follows: “Registration cost: $100.00; registration includes one full fare economy class airfare and room plus meals per registered attendee; spouses are welcome for a registration fee of $100.00; and children are welcome at a registration fee of $75.00.” Finally, the front cover of the flyer contained an illustration of a skier on the slopes.

Decision: The event contravened Section 4.2.3. of the Code as it was designated an “educational program,” but did not fulfill the five criteria necessary for an event to be so designated. It also contravened Section 4.3.4. because of the emphasis on the social aspects of the program (skiing), and also Section 4.3.5. as the registration charges did not reflect the actual costs of airfare and hotel accommodation, and therefore the company subsidized those costs.

Further discussion: On being informed of the Committee's decision, the company responded that the event “was designed to be a promotional event only,” as evidenced by inclusion of the word “Launch” in the title, and that use of the phrase “educational program” resulted from an error on the part of an employee.

Decision: The Committee confirmed its original decision that three sub-sections of Section 4 of the Code had been breached and cited the following in confirming its decision: designation of the event as an “educational program,” use of the phrase “supported by an unrestricted educational grant…” as well as the outline of the program's objectives. Finally, the Committee concurred that an error by an employee does not nullify the occurrence of a Code contravention.

2. Company and Issue: AstraZeneca Canada Inc. Event entitled “Straight from the Experts,” “continuing medical education” held at the IMAX Paramount (Chinook Shopping Centre), Calgary. The program featured two presentations - one on Asthma Management, and the other on Dyspepsia, each followed by a question and answer period. Participants were provided with a copy of the most recent Canadian Asthma Consensus Guidelines and a supplement to the CMAJ publication “An Evidence-Based Approach to the Management of Uninvestigated Dyspepsia in the Era of Helicobacter Pylori.” Affixed to the flyer for the event was an invitation, which read: “Your family is invited to a wonderful experience with Cirque du Soleil at the IMAX Paramount at 12 p.m.”

Discussion: Prior to ruling on the event, the Committee sought and obtained further details from the company, which confirmed that the program was designated “continuing medical education,” and that AstraZeneca representatives had paid for the IMAX screening.

Decision: Contravention of 4.2.3 - incorrect designation of event as “education,” and contravention of 4.3.4. - payment for social activity, other than meals.

3. Company and Issue: Aventis Pharma Inc. 1. Advertising for enoxaparin (Lovenox) in “Standards of care in acute coronary syndromes: Are our practices evidence-based?” A report from a satellite symposium at the 22nd Annual Professional Practice Conference of the Canadian Society of Hospital Pharmacists. 2. Advertising for Altace in publication entitled “Are all ACE Inhibitors alike? Can we use the class effect for all therapeutic goals?” 3. Advertising for Renedil in publication entitled “Advances in the management of hypertension with Dihydropyridine Calcium Channel Blockers.”

Discussion: Each of the pieces was found by the Commissioner of the Pharmaceutical Advertising Advisory Board (PAAB) to contravene the PAAB's Code of Advertising Acceptance in that they had not been submitted for preclearance.

Decision: Contravention of Section 2.2.1. of Rx&D's Code which obligates member companies to adhere to the PAAB's Code. (Above three items counted as one contravention on recommendation of the PAAB's Commissioner).

4. Company and Issue: Aventis Pharma Inc. Event entitled “Cardiovascular Consultation Meeting,” held February 22 to 25, 2001 at the British Colonial Hilton, Paradise Island, Nassau, Bahamas.

Discussion: Evidence provided in support of the allegation consisted of a letter of invitation addressed to individual physicians, co-signed by two employees of the company, together with a Hotel and Travel Form indicating that transportation (hospitality class) and lodging costs would be covered by the company.

The letter stated that the event would “address two main streams - Standards of Care in Acute Coronary Syndromes and Management of Cardiovascular High Risk Patients.” It also advised that “educational tools pertaining to the aforementioned topics will also be discussed and provided for participants to implement in their own work settings.” The letter also included the statement: “Due to the high level of interest in this program, we recommend that you register as soon as possible. “This symposium is limited to 34 participants.”

Among the points noted by the Committee during their ongoing discussions of the event were the following: the original invitation to the physicians was very general in nature, and did not outline the questions on which the company wanted to consult; the “educational tools” referred to in the invitation were not provided in advance of the meeting so invitees could not be certain as to what precisely was being required of them; the original invitation intimated that the meeting would be a “train-the-trainer” session, however, the key questions for the meeting, as subsequently outlined by the Company, indicated that the event actually constituted market research as defined in Section 12.1 of Rx&D's Marketing Code; and finally, that view was borne out by the company's written statement that the “meeting is part of our consultation process in order to refine our strategy in cardiology.” The Committee sought further details including the selection criteria used for the participants, the way in which the maximum number of participants was determined, and the components of the documentation package distributed at the event.

Decision: Event conformed to the definition of “market research,” as outlined in Section 12.1 of the Code. As a result, it contravened Section 12.2.1, which requires that the purpose of an individual or group interview must be made clear to the participant(s), and that market research must not be a disguise for selling or developing sales contacts.

SUMMARY - REPORT #43