Mixing Dinner and Drugs—Is It Ethically Contraindicated?

doi:10.1001/journalofethics.2015.17.8.sect1-1508

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…The nurse ambassador program capitalizes on the honesty and ethics associated with the nursing profession, yet nurses are encouraged to make choices based on profit incentives rather than patient needs. Similarly, physicians and other prescribing clinicians should be mindful of the long-standing marketing techniques of pharmaceutical companies that have been associated with increased prescriptions and led to the profession issuing guidance on acceptable interactions with the industry …”

Section: Implications Of the Settlementmentioning

confidence: 99%

Problematic Promotion of Medications by Nurse Ambassadors—Legal and Ethical Issues

Yang

Mason

2021

JAMA

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A number of pharmaceutical companies offer nurse ambassador programs that typically involve companyemployed registered nurses who interact with patients to help facilitate the use of complicated medications that have been prescribed for the patient. However, some of these companies have been the subject of lawsuits alleging that their programs are inappropriately blurring the line between caregiver and marketer. In August 2020, the pharmaceutical company AbbVie agreed to pay California $24 million to settle a whistleblower case that involved its nurse ambassador program for adalimumab (Humira), while not admitting any wrongdoing. 1 Nurse ambassador programs in part aim to ensure that patients continue the use of costly medications and have provided incentives to physicians and other clinicians to prescribe the medication. The programs continue to be largely unregulated by the federal government, with US Department of Justice guidance suggesting that the program could have an important role in patient interactions in some cases. 2 Nurse ambassador programs are not confined to AbbVie. 3 Companies such as Lilly, Gilead Sciences, Bayer, Amgen, AstraZeneca, Vanda Pharmaceuticals, Berlex, Pfizer, and EMD Serono have similar programs and sometimes refer to the nurses as patient or clinical "educators." 4 Although it is not known how many nurse ambassadors are currently employed in the United States or how many AbbVie employs, the company has nurse ambassador programs for 2 other medications (risankizumab-rzaa and glecaprevir/pibrentasvir). According to a report from 2018, one nurse reported that the company had 400 nurse ambassadors when she left the nurse ambassador program that year. 5 The AbbVie-California settlement provides guidance at the state level and suggests that the programs can continue with some changes, but legal and ethical concerns remain.

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Section: Implications Of the Settlementmentioning

confidence: 99%

Problematic Promotion of Medications by Nurse Ambassadors—Legal and Ethical Issues

Yang

Mason

2021

JAMA

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Commercial Interests in Continuing Medical Education: Where Do Electronic Health Record Vendors Fit?

et al. 2020

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The Accreditation Council for Continuing Medical Education (ACCME) will not accredit an organization that it defines as a commercial interest, that is an entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on, patients. Thus, commercial interests are not eligible to be accredited organizations offering continuing medical education (CME) credit to physicians. This decision is based on the concern that commercial interests may use CME events to market their products or services to physicians, who then might inappropriately prescribe or administer those products or services to patients. Studies have shown that CME events supported by pharmaceutical companies, for example, have influenced physicians’ prescribing behaviors. Currently, however, the ACCME does not recognize electronic health record (EHR) vendors, which are part of a multi-billion-dollar business, as commercial interests, and it accredits them to provide or directly influence CME events. Like pharmaceutical company-sponsored CME events, EHR vendor activities, which inherently only focus on use of the sponsoring vendor’s EHR system despite its potential intrinsic limitations, can lead to physician reciprocity. Such events also may inappropriately influence EHR system purchases, upgrades, and implementation decisions. These actions can negatively influence patient safety and care. Thus, the authors of this Perspective call on the ACCME to recognize EHR vendors as commercial interests and remove them from the list of accredited CME providers.

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A Mathematical Model of the Production Inventory Problem for Mixing Liquid Considering Preservation Facility

et al. 2021

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The mixing process of liquid products is a crucial activity in the industry of essential commodities like, medicine, pesticide, detergent, and so on. So, the mathematical study of the mixing problem is very much important to formulate a production inventory model of such type of items. In this work, the concept of the mixing problem is studied in the branch of production inventory. Here, a production model of mixed liquids with price-dependent demand and a stock-dependent production rate is formulated under preservation technology. In the formulation, first of all, the mixing process is presented mathematically with the help of simultaneous differential equations. Then, the mixed liquid produced in the mixing process is taken as a raw material of a manufacturing system. Then, all the cost components and average profit of the system are calculated. Now, the objective is to maximize the corresponding profit maximization problem along with the highly nonlinear objective function. Because of this, the mentioned maximization problem is solved numerically using MATHEMATICA software. In order to justify the validity of the model, two numerical examples are worked out. Finally, to show the impact of inventory parameters on the optimal policy, sensitivity analyses are performed and the obtained results are presented graphically.

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Mixing Dinner and Drugs—Is It Ethically Contraindicated?

Cited by 3 publications

References 13 publications

Problematic Promotion of Medications by Nurse Ambassadors—Legal and Ethical Issues

Problematic Promotion of Medications by Nurse Ambassadors—Legal and Ethical Issues

Commercial Interests in Continuing Medical Education: Where Do Electronic Health Record Vendors Fit?

A Mathematical Model of the Production Inventory Problem for Mixing Liquid Considering Preservation Facility

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