There is no such thing as a free lunch—especially in working with professional and patient groups. Although picking up the tab is now out of bounds, forging ties with third-party physician, patient, policy and payer groups remains critical: medical advances without advocacy involvement fall short. With the credibility questions stripped away, hopefully Beltway decision makers will acknowledge that quality and access-to-care depend on industry/third-party cooperation.

While company compliance officers raise the bar internally with colleagues, third-party organizations are increasing their own “no free lunch” vigilance following passage of the America’s Affordable Health Choices Act.

Senator Charles Grassley—one of the sponsors of the 2009 Physician Payments Sunshine Act, later expanded to include a wide range of health professionals and patient groups—wrote 18 months ago to the National Alliance on Mental Illness: “I have come to understand that money from the pharmaceutical industry shapes the practices of nonprofit organizations which purport to be independent in their viewpoints and actions.” Since then, he has followed up by probing scores of professional and patient associations to examine pharma/ third-party connections.

Past advocacy efforts often relied on financial support to increase symptom awareness, strengthen ties and fund outreach programs. The regulatory environment is working to limit influence of financial contributions via increased transparency requirements. The penalties to industry for noncompliance will be steep—fines of up to $10,000 for each $100 “transfer of value” not reported, and up to $100,000 for knowingly failing to report—with a cap of $1 million annually.

On September 30, 2011, the curtain covering any biopharma third-party support activity will be opened wide, and industry payments to third-party groups will be on a public, searchable website.

But let’s face facts: third-party partnerships are essential to disease education and improving therapy adherence. These industry-patient group alliances help the medical community recruit candidates for clinical trials, make people realize conditions may have treatments, and help families navigate an increasingly complex health system. Pharma companies must remember, however, that true advocacy always has been more than just a lunch invite. With consumer access to a vast ocean of internet information creating a public health dilemma—what’s fact and what’s fiction?—advocates and public educators are a lighthouse for truth.

Today, transparent connections between the pharma industry and third-parties signal to consumers that the communication is credible. Consider what would happen to cancer patients in a time-critical situation if therapies were not readily available on formulary. Where would patients turn if a treatment for a rare disorder had no patient-assistance program to help cover cost? Or, if physicians needed to better understand a side-effect profile of a certain drug in patient types? These issues are critical to patients, providers, and business—making advocacy a central player. Advocacy in a complex health system has finally earned a dedicated seat within pharma company disease franchises. While Congressional leaders are calling for accountability, financial transparency enables companies and groups to shift the dance to what matters most— patients. No longer is the conversation around who picks up the tab for lunch. That was never the point. It’s about ensuring that industry and third-party relationships enable communication to improve patient care.

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