PEDIATRICS Vol. 90 No. 2 August 1992, pp. 281-282
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Physicians' Interactions with Pharmaceutical Companies

LEWIS H. MARGOLIS MD, MPH1

1 Department of Maternal and Child Health, University of North Carolina, Chapel Hill, North Carolina 27514

In Reply.—

In my essay1 I suggested that the acceptance of gifts from pharmaceutical companies violates a duty of justice because gifts represent resources inappropriately taken from patients through the added costs of the drugs that they buy. Dr Procopio raises the larger question of how other types of promotional activities increase the cost of drugs in particular and medical care in general. His letter makes clear, however, that the contribution of an activity such as the distribution of samples to the cost of care is difficult to determine because several different purposes are served.