"We're able to offer really fun and exciting opening entertainment, but there's a purpose," explained Scott Cullather, founder and managing partner of inVNT.
At an upcoming internal meeting for a pharmaceutical company, a live band will open the agenda—and executives at events agency inVNT are not expecting to break any ethical guidelines, which could potentially discourage their client from entertaining the medical professionals in the audience, alongside its staff.
"The band is made up of patients who use a particular product," Cullather said. "The audience won't know that until after the performance is done."
That's when the company will kick off its educational presentations on the drug being discussed.
It's no secret that it's gotten ever more challenging for meeting professionals to plan events for the increasingly regulated pharmaceutical, biotechnology and medical communities in recent years. Not only do planners have to devote time to understanding existing restrictions, but they also have to find creative enough ways to work within those restrictions to keep clients happy.
In January 2009, voluntary guidelines from the Pharmaceutical Research and Manufacturers of America (PhRMA), a group of research-based pharmaceutical and biotechnology companies, took effect. The code is designed to help members make sure that they meet ethical and legal standards for interactions with medical professionals, offering suggestions on matters ranging from what types of business lunches are allowed for medical presentations ("in-office" and "in-hospital" settings are the gold standard) to the distribution of tickets to sporting events (they're verboten).
The underlying goal, as the PhRMA guidelines express, is to make sure that doctors and other healthcare professionals make decisions on patient care based solely on medical need—and that pre-launch and marketing activities don't inappropriately influence them or create the perception that this is happening. The code was built upon an earlier set of principles introduced in 2002.
"They're voluntary, in the hopes of staving off any legislation," said Steve Mapes, vice president of creative services for Impact Unlimited, a provider of brand communications for events, meetings and exhibits.
But the PhRMA code is not the only factor forcing meeting professionals to rethink their approach to events. U.S. pharmaceutical, biotech and medical supply and device companies covered under federal healthcare programs such as Medicare must prepare to comply with the Physician Payment Sunshine Act, a provision of the Patient Protection and Affordable Care Act of 2009, which was signed in March 2010 and takes effect January 2012. These firms will have to report any payments they've made to physicians over US$10—including consulting fees, entertainment, food and travel—to the U.S. Department of Health and Human Services. This information will be viewable by the public on a searchable online database. Companies that knowingly fail to file the required reports will face fines ranging from $10,000 to $100,000 for each infraction, with an annual limit of $1 million.
"With the Sunshine Act coming next year, some companies are very sensitive," Mapes said. "It has been good medicine for the industry. It has forced companies to focus on the message."
To stay a step ahead of the guidelines, one of Mapes' pharmaceutical clients is already scanning the badges of physicians who come to its booths at events for a cup of coffee—in order to track expenditures.
"Theoretically, there is an exchange of value," Mapes said.
While few observers would dispute that clear ethical guidelines are important for health-related industries, such rules do pose challenges for meeting professionals who are used to doing business in the less strictly regulated business environment of years gone by.
"In the beginning, it was a little paralyzing," said Tammi Runzler, senior vice president of convention sales and services for Visit Orlando, reflecting back on the introduction of the PhRMA code. "It was, 'Oh, no, we have these incredibly strict and stringent guidelines to adhere to.' Now we've had enough time to react and respond. It has forced us in so many ways to look for creative and meaningful options."
For instance, she says, the CVB has heightened its focus on educational events for the medical community, such as lunch-and-learn sessions where medical experts provide education on new medical technologies.
For many meeting professionals, complying with the guidelines means paying attention to subtleties that may have previously been second thoughts.
"I think you really need to strike a well balanced 'taste and tone' strategy," Cullather said. "You don't want the meeting to not be effective, engaging or motivational, but it can't be all flash and trash, either."
Airport Hotels Gain Favor
Choosing the right venue is an essential step to complying with PhRMA guidelines from the get-go, says Andy McNeill, CEO of American Meetings Inc., which gets about 80 percent of its business from biotech, pharmaceutical and healthcare clients. The days when a pharmaceutical company would rubber stamp a meeting at a tony vacation spot—or invite a physician and spouse for an expense-paid fishing trip—are clearly over, according to McNeill, who has been active in the meeting industry for more than 20 years.
"A standard that a lot of pharmaceutical firms use is that the word 'resort' can't be used in the name of the hotel. They don't want the perception that they are at a hotel that is resort-related," McNeill said, adding that large companies each have their own interpretations of PhRMA guidelines.
Events at casinos are also out, says Bill Cooney, founder and president of MedPoint Communications, a medical and clinical communications company. These days, he's seeing clients choose plainer lodgings that tell physicians, "We're not here to curry favor or entertain you. We're here to talk about medicine."
"Maybe it's a relatively nice hotel, but in the suburbs," he explained. "We've seen the profile move heavily away from glamorous venues."
While few business travelers relished the thought of staying at an airport hotel years ago, that's changed. Today, they're one of the prime spots for medical and pharmaceutical meetings.
American Meetings, for instance, recently organized one pharmaceutical client's advisory board meeting for physicians at the Westin Detroit Metropolitan Airport.
"It's a brand new facility, and it's a business hotel—standard nomenclature for 'not opulent,'" McNeill said.
It's not just PhRMA guidelines that are driving the trend—following the code helps to keep time-pressed attendees happy, too. Often, McNeill and other meeting professionals report, it's easier to get attendees to a one-day meeting at an airport than a conference that, with travel included, pares two or three days from their already packed schedules. To minimize doctors' time commitment, McNeill's client planned the Detroit meeting so that physicians could fly into the Detroit Metro Airport on Friday evening for an all-day session on Saturday that ended at 4 p.m., enabling many to fly home the same day.
"A lot of times it's about convenience nowadays," McNeill said. "Physicians are very, very busy. And our pharmaceutical clients are extremely busy trying to bring drugs to market."
That doesn't mean every attendee will be satisfied with an event that seems bare bones.
"It's important to select those venues that have a variety of different room types or options, so you can provide your executives with the quality of room they're used to," Cullather said.
And sometimes a planner can make a more compelling business case for using a property that calls itself a resort when a big event is being planned. Many medical and pharma events still require a lot of meeting and event space, Runzler says, for breakout sessions and numerous concurrent meetings.
In those cases, it may not be possible to secure enough room for a meeting at an airport hotel, so it's necessary to look at bigger properties.
Reading Between the Lines
Helping meeting organizers stay compliant isn't just about hotel selection. To meet the PhRMA guidelines, planners need to exercise the same care in choosing menus as they do in selecting lodgings.
At New York destination management firm Shackman Associates, founder Karen Shackman recently worked with a group of about 200 employees from a global pharmaceutical company who were in town to attend a large rheumatology conference, arranging dinners at restaurants around town for about four days. Manhattan's status as a dining capital made it relatively easy to find eateries near the group's Crown Plaza hotel base that offered a nice meal for $125 or less per head, the maximum that her client had set to stay within the guidelines. Still, Shackman had to work with some of the restaurants ahead of time to make sure the meals stayed within the code.
Because clients' interpretations of the PhRMA guidelines vary, she says it is sometimes tricky to understand exactly what they entail for a particular firm.
"We worked with one of the pharmaceutical companies in the veterinary division," Shackman said. "They seemed to be more stringent."
The challenge inherent in designing a meeting that complies with PhRMA guidelines depends, to some extent, on its purpose. Meetings on the research side of the pharmaceutical industry tend to be relatively free of ethical minefields, according to MedPoint's Cooney.
"There are relatively few restrictions on what you can do," he said. "There aren't a lot of truly significant conflicts of interest about holding these meetings. They're purely scientific."
As one might expect, gray areas are most common in meetings designed to help a pharmaceutical company market its drugs. For instance, pharmaceutical companies can spring for a meal for physicians, but Cooney says they cannot pay for their parking, transportation or overnight stay in a hotel. And if they pay for a meal, they have to be careful not to violate a federal law related to kickbacks.
"If you spend too much money on physicians, it could be considered influence buying," he said, noting that he's seen many pharmaceutical companies limiting meals to $100 per head.
Turning to technology is helping some meeting organizers and their planners stay compliant. Cooney has seen more than one client stop holding a large annual meeting to provide training to its bureau of speakers who educate doctors on new drugs. Instead, it breaks the meeting into five smaller regional events on the same day, reducing the need for overnight accommodations.
"At every location, you'll have 30 to 40 speakers meet," he said. "Many of the physicians can drive to those locations, or it's only regional flying."
Sometimes, all of the regional meetings will be connected by webconferencing, to bring all attendees together for certain sessions.
"It's still an effective meeting," he said. "It's still national in scope."
Mapes' company spends a lot of time these days mining technology tools that will enable it to better design educational experiences for a medical audience.
One display Impact Unlimited created for a gathering of psychiatric professionals used 3D technology to recreate some of the symptoms of schizophrenia. To replicate the sensation of smells being "off"—an affliction for some patients—Impact Unlimited created an experience in which the doctors could smell pizza with a weird odor.
"We do a lot of research on the disease state and talk with physicians to think of ways to tell the story," Mapes said.
Incorporating social media into meetings can also help. One challenging scenario for many companies following the guidelines is having a doctor who is a key opinion leader deliver an interactive presentation to an audience.
"There are so many things that could happen that could violate those regulations," Cullather said.
His answer is to use Twitter to receive (and completely vet) questions for the speaker ahead of time.
To ensure compliance, inVNT will typically arrange for a pharmaceutical company representative to share the stage with a medical expert to field the questions.
"If it's a live Q&A, and it's a question that might border on not being appropriate, the representative of the organization can intercept it and handle it effectively," he said.
Cullather believes that offering presentations by a variety of participants can also create a more balanced meeting that is less likely to lead to ethical complaints. At a meeting on managed care, for instance, they might hear from a doctor, a legislator and someone from the host organization who handles managed care.
"[By doing this], if there is anything presented that is 'borderline,' the risk of that is marginalized with the broader message," he said.
But technology can't solve every ethical conundrum. It's also important to use the meeting agenda to make sure physicians aren't lingering in a room at inappropriate times.
"Once you shift gears and become very specific on your products, your strategies and your marketing plans, it's important to make sure the reps have space," Cullather said.
Rather than awkwardly herding the doctors out of the room, he prefers to plan a break in the program or a meeting for physicians with a senior executive of the pharmaceutical company in another room.
"You can get them to leave without [tersely] saying, 'We need you to leave now,'" Cullather explained.
As meeting planners become increasingly well prepared to deal with the ethical codes and regulations affecting their clients, carefully orchestrated exits like these are likely to become far more common in years to come. One+
Tips for a Successful and Compliant Event
- Increase the focus on educational events for the medical community, such as lunch-and-learn sessions.
- Try airport hotels. Not only do they lack the stigma of venues with "resort" and "casino" names, they're easier on physicians' busy schedules and permit smoother in-and-out single-day programs.
- Utilizing webconferencing technology to connect simultaneous regional events can reduce the need of overnight stays expected at a single large event.
- Incorporate social media to vet audience questions for speakers ahead of time.
