One of the significant developments during 2006 was the increasing number of medical schools and academic medical centers that have adopted strict new policies to limit the influence of the pharmaceutical industry, including taking steps to exclude pharmaceutical sales reps from many areas of campus where they used to have free access. The single policy that probably got the most press was at Stanford University; see their policy at: http://med.stanford.edu/coi/siip/documents/siip_policy_aug06.pdf
Other medical centers adopting tough policies in 2006 included Yale, UCLA, and Henry Ford in Detroit, with the U. of Virginia considering following suit (Zinie Chen Sampson, Associated Press, 1/18/07). Earlier schools to join the list include Wisconsin, Michigan and Pennsylvania. A more recent article in the LA Times indicated that UC-Davis was also about to adopt such a policy:
In at least some cases, the impetus for these policies may have been less a matter of ethical sensitivity on the part of the medical center, and more a fear of increased costs as reps marketed the most expensive new drugs to faculty and house staff. (Anecdotal reports would seem to indicate that the drug bills for some of these academic medical centers did indeed fall after the reps were largely banned.) More recently, I sense that there is a true concern for ethics and professionalism in prompting these measures--and this was the angle stressed by the LA Times story, which focused on the "pharm-free" movement among medical students. If in fact the wind is starting to blow in an anti-Pharma direction, these policies may be a bellwether. According to the LA Times account, a turning point may have been the appearance of an article by a number of distinguished academic physicians in JAMA about a year ago calling for these tough new policies in academic medical centers: Brennan TA, Rothman TJ, Blank L, et al. Health industry practices that cretae conflicts of interest: a policy proposal for academic medical centers. JAMA 2006; 295:429-433.