Code of Marketing Practices

Marketing Practices Review Committee

Report on Code Infractions # 45: March 1, 2002 to May 30, 2002

1. Company and Issue: Berlex Canada Inc. Distribution of stirrup covers - gray and green in colour, bearing the product name, Mirena.

Discussion: The Company stated that the stirrup covers were distributed to physicians at meetings of the Society of Obstetricians and Gynecologists following the completion of a skill-testing question, and that they were designed to enhance patient comfort during the insertion procedure. In examining the Company's explanatory comments, the Committee affirmed that patient comfort is not part of the definition of an “acceptable service-oriented item” as outlined in Section 11.2 of the Marketing Code, and that distribution of the items constituted a “special promotion” as described in Section 11.1

Decision: The stirrups were found to be in contravention of Sections 11.1 and 11.2 of the Marketing Code.

2. Company and Issue: Merck Frosst Canada & Co. Event entitled “Family Physician Sunday Evening Clinical Update” held April 21, 2002 at La Chaumière Restaurant, Calgary, AB.

Discussion: The program featured two presentations - one on Osteoporosis and the other on Hypertension. There was a reception at 5:30 p.m., with the presentations beginning at 6:00 p.m., followed by dinner. The invitation to the event included the names and telephone coordinates of two of the Company's representatives. It also included the following statement: “This program has been submitted to the CFPC for approval of Mainpro M1 credits.”

Decision: The event was found to contravene Section 4A.1.2 of the Code because of the inclusion of the above-mentioned statement which is prohibited by the College of Family Physicians of Canada's publication MAINPRO: A Guide for CME Providers, 2001. Section 4A1.2 of the Rx&D Code obligates the Rx&D membership “to support, where possible, the principles and practices” of organizations such as the CFPC.

3. Company and Issue: Pfizer Canada Inc. Distribution of a plastic tote bag bearing the Pfizer logo and tagline “Life is our life's work/Notre passion, la vie,” as well as the names of several of the Company's products.

Discussion: The Company confirmed that some of the bags were distributed at trade shows intended for health care practitioners.

Decision: The tote bags were found to contravene Section 11.1 of the Marketing Code.

4. Companies and Issue: Procter & Gamble Inc. and Aventis Pharma Inc. Event entitled “D'agir aujourd'hui pour prévenir demain avec Actonel” held at the Centre Hospitalier des Vallées de l'Outaouais, Hull, Quebec, March 21, 2001.

Discussion: The event was billed as a “conférence scientifique axée sur l'Ostéoporose” and the invitation listed four educational objectives of the single presentation which constituted the program. The invitation also stated that a dinner would follow the conference and would be held at the restaurant Laurier sur Montcalm. It provided the names and telephone coordinates of one representative from each of the two companies. While the event was designated a “conférence scientifique,” there was no indication that it was either accredited or adhered to the principles of adult learning, as required by the Code for such a designation.

Decision: The event was found to contravene Section 4.2.3 of the Code.

MPRC note: The MPRC Report on Infractions # 44 contained, as Item #1, an outline of an infraction by Aventis Pharma Inc. in respect of an event entitled “Osteoporosis Program,” held November 3, 2001 at the Delta Edmonton Centre Suites Hotel, and the Summary of that report showed Aventis at having arrived at a fourth infraction of the Code with the “Osteoporosis Program.” While Aventis had indeed arrived at a fourth infraction with the release of Report #44, the fourth infraction applies to the “Actonel” event rather than the “Osteoporosis Program.”

5. Company and Issue: Wyeth-Ayerst Canada Inc. Event entitled “Formation médicale continue,” held March 23 & 24, 2002, Hotel Gray Rocks, Tremblant, QC.

Discussion: The program provided for arrival, lunch, dinner and one presentation (“Dépression chez la personne âgée”) on the first day, and breakfast, dinner and two presentations (“Dépression: Comment atteindre la rémission” and “Trouble d'hyperactivité chez l'adulte”) on the second day. The invitation to the health care practitioners also listed many recreational activities available on site, including an offer of “two days of skiing at Gray Rocks or Mont-Blanc for you and your family.” The Company confirmed that physicians paid an amount ranging from $105.00 to $260.00 to cover the cost of their accommodation and the expenses of their guests, and that the ski tickets were included in the cost of accommodation. Finally, the invitation also contained the names and telephone coordinates of two of the Company's representatives. The Marketing Code requires that events designated continuing medical education must either be accredited or meet the principles of adult learning.

Decision: Following confirmation by the Company that the event was neither accredited nor met the priniciples of adult learning, the Committee found the event to be in contravention of Section 4A2.3 of the Code.

6. Company and Issue: Wyeth-Ayerst Canada Inc. Distribution of patient appointment cards bearing the product name, Alesse 28.

Discussion: One side of the card contained the product name Alesse 28, diagrams of pills covering 28 days, and under which were inscribed the days of the week. The other side contained space for the physician's name and phone number, the day and time of the patient's next appointment, and the following: “Conseil: Si vous fumez et prenez un contraceptif oral, vous vous exposez à un plus grand risque de développer une maladie cardio-vasculaire (maladie qui affecte les artères et les veines). Le risque de crise cardiaque d'accident cérébro-vasculaire ou de formation de caillots augmente également, surtout si vous avez plus de 35 ans.”

The Company stated that the cards deal directly with issues affecting oral contraceptive use, and are intended to counsel the patient on events that may occur when they take oral contraceptives, or to remind them of the risks involved in smoking and taking oral contraceptives. The Company also stated that the appointment cards were intended to assist physicians with counselling thereby reducing the number of unintended pregnancies each year, and that they are intended to be given only to those patients taking the medication, Alesse. In outlining its position, the Company provided additional examples of identical cards, each containing a different “Tip,” and stressed that, as a company involved in women's health care, it has a responsibility to help reduce the number of unintended pregnancies.

Decision: The Committee's conclusion was that the primary goal of the cards was to further advertise the product Alesse 28 and not, as required in Section 11.2 of the Code “…to enhance the healthcare practitioner's/patient's understanding of a condition or its treatment.” As a result, the item was found to contravene Section 11.2.

MPRC note: The Company filed an appeal of the Committee's decision, and a hearing was convened in accordance with the Enforcement provisions of the Marketing Code. The arbitrator of the appeal upheld the Committee's decision.

SUMMARY - REPORT #45