The University of Pittsburgh Medical Center has enacted a far-reaching new ethics policy that cures a weakness that would have banned the practice of distributing free drug samples.

The conflict-of-interest policy will go a long way in restricting the ability of manufacturers of drugs and medical devices to curry favor with doctors and employees of the health system and Pitt's Schools of the Health Sciences. It will prohibit employees and students from accepting gifts and tickets, regardless of their value, and most food. It mandates that any consulting relationships between doctors and manufacturers be approved in advance, and it means industry representatives can't pay for staff travel and attendance at meetings unless they are speakers. When they are, there are limits on expenses and compensation.

The major change from a draft policy issued earlier this year concerns what to do about free samples of drugs and medical devices, which would have been banned. The practice of dispensing samples, a two-edged sword in the medical community, will continue in some form. Although studies have shown that the use of samples boosts drug sales and encourages the use of new, higher-cost medications, some patients will try new drugs only if they get them directly from the doctor. Others can't afford them.

UPMC has not worked out all the details of how to control the practice of sampling, but it has assembled a group of pharmacists, physicians and administrators to do so. What is known is that a central UPMC facility will accept samples from drug companies and then provide them to doctors' offices. This system will result in a better inventory of drugs and they can be sent to the offices where they most likely will be needed, all the while keeping the process simple for patients.

One policy won't cure all of the unhealthy relationships between physicians and drug companies, but UPMC has laid a foundation for a long-term remedy.