Online conferences

Legislation: Not applicable.

MA Code of Conduct

The MA Code of Conduct as it relates to in-person events and hospitality also applies to online conferences.

Hospitality must be reasonable and appropriate, and uphold the integrity and reputation of the industry.

• It is appropriate to use a meal delivery service to provide hospitality to a HCP in their workplace during their workday. This should be done in the presence of a company staff member (whether physically or virtually) or in conjunction with a formal educational activity (such as a webinar, journal club, or grand rounds).
• It is not appropriate to provide hospitality to a HCP in the absence of a company staff member (whether physically or virtually), and without educational balance.
• Hospitality should not be provided to a HCP in their own home. This is irrespective of whether they are participating in a webinar or other form of educational activity.

See Medicine Australia’s Brief on Virtual Meetings.

Legislation: Not applicable.

MA Code of Conduct

Companies may host or sponsor educational conferences, symposia, and scientific meetings that are fully online.  The principles of providing current, balanced, accurate and scientifically valid information still apply.

Companies will need to be mindful of the following matters:

• Access to these activities should be for verified HCPs only. This means making sure video conferencing tools can be locked down for registered delegates only.
• Promotional messages must be relevant to the target audience (e.g., products should not be promoted unless there are attendees from a location where the product is registered).
• Unapproved products and indications should not be promoted.  Educational information about unapproved products and indications can be shared in the spirit of scientific exchange, however this must comply with section 8 of the MA Code of Conduct and be approved by a company’s Medical team without a commercial function.

All necessary regulatory approvals must be obtained in advance. 

The scientific material shall be directly related to health or health services and shall depend on the most recent scientific references and the essential periodicals in the specialty.

The activity should be presented in English and should be in clear scientific language.

The individual who presents should be a specialized academic or have a postgraduate degree in the field of the scientific topic being presented.

The conference shall be interactive through which communication between the service provider and recipient is achieved.

There must be a supervisor responsible for the site and there has to be a clear mechanism to communicate with him.

The conference shall have clear procedures for admission and registration in the system.

The scientific material should be in the form of a scientific article along the lines of what is written in specialized scientific journals and references shall be mentioned.

The scientific material may be presented in the form of power point slides or a film provided that the material is accompanied by audio or written explanation.

Scientific material shall be evaluated by an independent scientific committee and members of university professors who are highly specialized in the same area of the scientific contents.

In case of an exclusively virtual scientific event, the above rule of at least six hours of scientific activity does not apply. No minimum number of hours of scientific activities is prescribed for virtual scientific events.

In case of participation in a virtual scientific event or a hybrid scientific event in which the healthcare professional participates virtually, the hospitality offered must be limited to the registration fee to participate in the scientific event. Neither meals (e.g. boxes or vouchers) nor other hospitality can be offered.

Statutory Laws

No specific rules. Any specifics must be assessed on the case-by-case basis.

INTERFARMA

All the rules applicable to traditional events are also applicable to online events.

SINDUSFARMA

No specific rules. Any specifics must be assessed on the case-by-case basis.

ACESSA

Compensation or honoraria to HCPs for services provided must be reasonable and reflect the fair market value (FMV) of the services, taking into account reasonable differences that may arise from performing services in a virtual environment (for example, the absence of travel). Compensation should be calculated on time spent for services rendered and must exclude any ancillary fees or expenses (i.e., Internet fees, Zoom).

It is not recommended to provide meals to HCPs during virtual interactions. However, if a meal is provided in the course of a virtual interaction, the following criteria should be followed:

• The meal is incidental to the business discussion;
• The interaction takes place in an organized group interaction such as learning programs or advisory boards;
• The meal provided is limited to only those invited and confirmed HCPs for the event/activity;
• HCPs are in an appropriate business location or clinical setting and not a personal residence; and
• The meeting occurs during regular meal hours.

The provision of meals during promotional/detailing activities with HCPs is not considered appropriate, neither is the provision of alcoholic beverages during any virtual interactions.

Meal vouchers (or other cash equivalents) may not be provided, and HCPs may not be reimbursed for meals purchased independently. Meals must be reasonable, and Members should continually assess internal meal expenditure limits, including determining whether existing meal limits are appropriate for a virtual setting, taking into account delivery charges.

RTVSS: None.

AFIDRO'S Code of Ethics: Companies may organize, sponsor or support face-to-face, hybrid and virtual events, aimed at HCP, in order to improve their level of knowledge in matters related to health care, the improvement of the quality of life of patients, the provision of health services or the sustainability of the system, among others.

The objective of events organized, sponsored or supported by companies and aimed to HCP should be to provide scientific or educational information and/or inform about medicines in support of improved health care and patient care.

ANDI's Chamber of Pharmaceutical Industry Code of Ethics and Transparency: None.

RTVSS: None.

AFIDRO'S Code of Ethics:

• The Code of Ethics, the current regulations and doctrine applicable to interactions with HCP will be extended to virtual interactions. Initiatives related to virtual interactions must obey the legitimate needs of the health sector.
• Virtual interactions should be directed to the relevant HPC and designed according to the specific purpose of the interaction. Companies should ensure that the audience participating in each of the virtual interactions is appropriate in accordance with legal or regulatory requirements on the matter.
• For virtual interactions, all HCP who have previously given their consent to be contacted through virtual means can be contacted, in order to comply with applicable local laws.
• The platforms to be used for contact between the pharmaceutical industry and HCP should provide the highest possible standards of reliability in terms of information security.
• During virtual interactions organized by pharmaceutical companies, it is necessary to ensure proper review and approval of materials and/or visual aids that are in compliance with local regulations.
• In the use of virtual interactions, pharmaceutical companies should provide information on the channels for reporting adverse events and other pharmacovigilance requirements, when applicable.

ANDI's Chamber of Pharmaceutical Industry Code of Ethics and Transparency: None.

ANDI's Chamber of Medical Devices and Health Supplies Code of Ethics: None.

The Ordinance: no specific provisions.

The Code: no specific provisions.

The Ordinance: it is noteworthy that, pursuant to Article 22 (1) lit. 6 of the Ordinance, without health workers’ prior consent, it is prohibited to advertise medicinal products via e-mail or other means of electronic communication.

The Code: no specific provisions.

Please see our answers to the other sections above.

In case of online conferences, the pharmaceutical companies should not pay any expenses associated with HCPs’ online conference participation, except for the participation fee.

In principle, the rules of promotion for physical and virtual meetings are the same. However, it is ENLI's recommendation that companies should carefully consider whether to provide refreshments to the participants when, for example, the rep.-meeting takes place virtually instead of the usual personal attendance, where, for example, fruit, cake, etc. is provided. Sending catering – especially if participants are sitting on their home addresses, can send the wrong signals.

It is noted that EFPIA in their "EFPIA Code of practice: ethical guidance in light of COVID-19", which can be found at www.enli.dk, states that member companies cannot offer catering to healthcare professionals who individually participate in a virtual third-party organized event. Similarly, Medicines for Europe's Code of Conduct states that companies may not provide or sponsor catering to individual participants in virtual meetings. However, meals can be provided if some of the participants are physically gathered with a representative of the pharmaceutical company while attending a virtual meeting together, cf. Medicines for Europe Code of Conduct art. 5.7.7.

For on-demand meetings, it is ENLI's assessment that catering cannot be provided, as it cannot be ensured in these cases that the healthcare professional will actually attend the continuing education meeting or when this will happen.

Therefore, the considerations for catering are based solely on the live-streamed virtual meetings, and ENLI generally recommends that no catering be offered, cf. Art 1 of the Promotion Code. ((ENLI, Guidance on” The Pharmaceutical Industry's Code of Practice on Promotion etc., of Medicinal Products aimed at Healthcare Professionals" (The Promotion Code), p 77).

Section 21(8) of the Promotion Code stipulating the specific information which must be included in an event invitation addressed to a HCP applies to both physical as well as virtual events (ENLI, Guidance on “The Pharmaceutical Industry's Code of Practice on Promotion etc., of Medicinal Products aimed at Healthcare Professionals" (The Promotion Code), p. 114-115).

The Code applies to information distributed both on a personal basis and through the communication media. Therefore, the scope of application of the PIF Code also includes any operations taking place on the Internet, social media and other electronic communications media.

Additional rules applicable specifically to online conferences (incl. communication / advertising rules in relation to events attended by multinational audience)

The Finnish Medicines Act or Degree 

No specific rules 

Code of Ethics issued by Pharma Industry Finland 

No specific rules 

See the general principles on hospitality in Accommodation.

No specific rules. Hospitality would not be justified in this case.

Please note that French law strictly regulates on-line health-related promotion (e.g. ANSM Internet Charter).

StGB

Generally, all key regulations apply to traditional events as well as online conferences.

No specific rules.

HWG

Generally, all key regulations apply to traditional events as well as online conferences.

UWG

Generally, all key regulations apply to traditional events as well as online conferences.

FSA Code of Conduct Healthcare Professionals

Generally, all key rules apply to traditional events as well as online conferences.

StGB

Not applicable.

HWG

Not applicable.

UWG

Not applicable.

FSA Code of Conduct Healthcare Professionals

Not applicable.

Measures of implementation for Regulation (EU) 2019/1150 on promoting fairness and transparency for business users of online intermediation services have been adopted by Greek Law 4753/2020.

An HCP cannot be renumerated for attending a scientific meeting or to compensate for his time. 

Nevertheless, as indicated in EOF’s Circular Nr. 37201/23.03.2020, hospitality and travel expenses and registration fees, including passwords for online scientific events, may be covered by pharmaceutical companies, given the EOF’s and the HCP employer’s prior approval.

Compliance with applicable data privacy legal provisions shall be observed when using electronic communication means.

Electronic communications may also be implemented for promotional activities provided that express authorization has been previously granted by relevant authority.

There are no express rules or restrictions applying to online conferences.  However, Industry Codes to online conferences apply with any necessary modifications.

Generally speaking, acceptance of hospitality can create conflicts of interest and HCPs should be satisfied that their actions will not lead to a perceived loss of professional independence.

Medicines New Zealand Code of Practice

• All electronic promotional material must comply with the requirements for Full or Short advertisement (to include technical information and substantiating references). Information intended only for use by HCPs must be provided via a secure platform.

For virtual participation in events /work meetings at which the LMI Member Company’s representative is not physically present, cf. 15.1, hospitality rate A applies, regardless of whether the meeting includes over 90 minutes of professional content.

It is forbidden to finance the full participation fee for digital events arranged by a foreign/international third party.

Alcohol must never be served in connection with digital events.

There are no specific rules applicable to online conferences. Rules applicable to the traditional events apply with the necessary adjustments.

No specific rules.

With regard to webinars, the Agency for Medicinal Products and Medical Devices of the Republic of Slovenia recommends that online conferences invitations are sent in a manner that does not allow the abuse of passwords to access the same.

Online activities are subject to the Code. No hospitality can be offered (social events, travel, accommodation and/or maintenance), whether the meetings are organized by a pharmaceutical company or by a third party.

Companies must comply with applicable legislation, including data protection regulations.

• The promotion of medicines to HCPs through digital media should be conducted in a technical-scientific or professional context.
• Companies must ensure that this publicity is only aimed to these groups (HCPs).
• In promotional online events there must be a system in place in order to verify that the participants of the online conference are in fact HCPs and a clear and legible warning must be included indicating that this information is aimed exclusively at HCPs.

Under the Ethical Rules for the Pharmaceutical Industry:

• No meals allowed.
• Certain rules regarding invitations to online events which are advertised openly in printed or web based media, which is directed to a larger target group, apply.

ABPI Code

The guidance as it relates to in-person events/meetings also applies to online conferences.

Bribery Act

The granting of access to an online conference for free, that would otherwise be paid for, could be seen as an “other advantage” under the Bribery Act, depending on the circumstances. As with all of the guidance above care should be taken to ensure that engagemet with HCPs in conenction with an online conference is not such that it could be seen as intending to induce or reward improper performance of a relevant function or activity.

UK Advertising Legislation (including the Blue Guide and PAGB Code)

If broadcasting to a UK audience, then the online conference may fall subject to UK advertising laws. Some key principles set out in UK advertising laws are:

• to ensure that any communications are clear, accurate and not misleading (this includes not exaggerating the capability or performance of the products); and
• to ensure that any claims made are within the scope of the CE marking, align with the intended purpose of the product, and are sustainable by reference to the technical file of the product.

The Blue Guide and PAGB Codes

As well as the Blue Guide, consideration should also be given to the PAGB Code concerning the marketing of over-the-counter medicines (where such marketing is aimed at persons qualified to prescribe and supply, and those working for them).

ABPI Code

Companies should be aware that promotion at international events/meetings held in the UK may, on occasion, pose certain problems with regard to medicines or indications for medicines which do not have a marketing authorisation in the UK (although they are so authorised in another major industrialised country).

General Principle in the US: US government- and industry-issued guidance generally distinguish between two categories:

1. The potential for an industry role relative to travel and hospitality expenses (payment for, or reimbursement for, such expenses) in connection with company-sponsored events, meetings, or HCP services.  This may include some meetings with educational or scientific content, but the content is controlled by the company.  This category may also include travel and hospitality associated with HCP’s engaged to provide services for the company (e.g., consultants or clinical investigators).  This category is the focus of the US responses provided above for this survey.  Relative to this category and with consideration of online formats, note:
   • Federal Guidance: In general, in light of significant restrictions on travel due to the COVID-19 pandemic, industry-sponsored or funded travel and hospitality is likely to be subject to a higher degree of scrutiny under the relevant standards (e.g., bona fide need, reasonableness). In one specific example, under the OIG Special Fraud Alert on Speaker Programs, industry can anticipate a higher degree of scrutiny of the justification for in-person events when it is possible to provide information virtually.
   • State Laws and Implementing Regulations: Some states specifically address the provision of honoraria for company-sponsored events.  For example, Maine limits the aggregate value of all cash and gifts received by an HCP for a particular speaking engagement to an annual limit of $500 in retail value. 
   • Industry Codes of Conduct: The PhRMA Code already addressed an expectation that if meals are provided there must be a reasonable expectation that the HCP will remain present throughout the event. Supplementing this, PhRMA’s Statement on Application of PhRMA Code Section 2 During Emergency Periods addresses the provision of meals in conjunction with virtual information presentations to HCPs during the COVID-19 pandemic. PhRMA states that meals should only be provided if there is a reasonable expectation that the HCP will remain present (e.g., virtually “present” over video or audio conferencing) throughout the event, and any meals offered in connection with informational presentation made by field sales representatives or their immediate managers should continue to be limited to in-office or in-hospital settings. 
2. The potential for industry financial support in connection with independent continuing medical education ("CME") or similar third-party conferences or events where the company does not control or influence content. (Note: If a company has engaged an HCP to present on behalf of the company at an event, this should be treated as a consulting arrangement, subject to considerations under category (1) above.)
   • The PhRMA Code states: "Since the giving of any subsidy directly to a health care professional by a company may be viewed as an inappropriate cash gift," any financial support should be given to the CME provider or conference’s sponsor, which, in turn, can use the money to reduce the overall  registration fee for all attendees.
   • The AdvaMed Code states that companies cannot provide direct contributions to individual HCPs or pay directly for individual HCPs registration fees. Educational grants provided by companies directly to third party program organizers can be used by these organizers to allow HCPs-in-training (for example, medical and nursing students, residents, etc.) to attend the program, provided that the Company does not select or control the selection of the specific HCPs-in-training who will benefit.
   • Some states (e.g., Massachusetts) specifically prohibit the reimbursement of costs for health care providers to participate in any CME event or third-party scientific or educational conferences, while others incorporate PhRMA Code and/or AdvaMed Code standards by reference.
   • The Accreditation Council for Continuing Medical Education ("ACCME") Standards for Continuing Medical Education sets forth standards regarding industry support of CME.  For example, the ACCME states that industry grants may not be used for travel, lodging, honoraria, or personal expenses for non-teacher or non-author participants of a CME activity.  The CME provider may use commercial support to pay for travel, lodging, honoraria, or personal expenses for bona fide employees and volunteers of the provider, joint providers or educational partners.
   • Given that in the US, industry should not generally be providing funds or reimbursement directly to HCPs in connection with attendance at, or travel to and from, independent third-party events, this topic is not further covered in the US survey responses. 

Refer to the General Principle in the US describing the distinction between company-sponsored and independent third-party events.

With respect to company-sponsored events, PhRMA's Statement on Application of PhRMA Code Section 2 During Emergency Periods addresses the provision of meals in conjunction with virtual presentations to HCPs during the COVID-19 pandemic.  Meals may only be provided if there is a reasonable expectation that the HCP will remain present throughout the event, and meals should continue to be limited to in-office or in-hospital settings.