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From YouTube: Committee on Public Health and Human Services 11-30-2018
Description
The Committee on Public Health and Human Services of the Council of the City of Philadelphia held a Public Hearing on Friday, November 30, 2018 to hear testimony on the following item:
180888 An Ordinance amending Title 6 of The Philadelphia Code, entitled "Health Code," by adding a new Chapter 6-1200, entitled "Pharmaceutical Sales and Marketing Practices," to provide for registration of pharmaceutical manufacturer agents and certain other requirements; and to prohibit gifts by pharmaceutical manufacturers and their agents to health care practitioners; all under certain terms and conditions.
Committee on Public Health and Human Services
Chair: Councilwoman Cindy Bass (8th District)
Vice Chair: Councilwoman Maria D. Quiñones-Sánchez (7th District)
A
Morning,
this
hearing
is
called
to
order.
This
is
the
public
hearing
of
the
City
Council
Committee
on
Public
Health
and
Human
Services,
and
the
purpose
of
this
public
hearing
is
to
hear
testimony
on
bill
number
one:
eight
zero.
Eight
eight
eight
I
want
to
recognize
the
presence
of
a
quorum
of
committee
members
members
of
the
committee
who
are
in
attendance,
our
councilmember
Maria
kin-yuen,
a
Sanchez
councilman
al
Tagum,
burger
councilman
bill
Greenlee
and
Councilwoman
Blondo
Reynolds
Brown,
and
can
we
now
have
the
clerk
read
the
title
of
the
bill
bill.
B
Number
one:
eight
zero,
eight
eight
eight
amending
title:
six
of
the
Philadelphia
Code
entitled
health
code
by
adding
a
new
chapter;
six
12
hundred
entitled
pharmaceutical
sales
and
marketing
practices
to
provide
for
registration
of
pharmaceutical
manufacturer
ages
and
certain
other
requirements,
and
to
prohibit
gifts
by
pharmaceutical
manufacturers
and
their
agents
to
healthcare
practitioners
all
under
certain
terms
and
conditions.
Okay,.
A
And
does
anyone
have
any
opening
testimony
before
or
any
opening
comments?
I
would
like
to
make
a
comment,
and
the
first
is
that
I'd
like
to
thank
everyone
for
being
here
today,
and
you
know
particularly
the
members
of
the
committee
who
were
able
to
make
it
because,
as
members
of
council,
you
know
sometimes
when
the
when
it's
time
to
take
a
vote
and
the
votes
may
not
be
comfortable
for
you.
A
It's
moments
like
this,
in
which
there
is
you
know,
has
to
be
recognition
where
we're
paying
attention
to
doing
what's
right,
we're
trying
to
do
what's
right,
where
we
are
taking
votes
that
are
not
always
necessarily
comfortable
for
everyone
up
here,
but
that
is
the
job
as
a
member
of
City
Council
that
we
are
to
do.
That
is
what
we
are
here
for
to
do
our
own
research
to
do
our
own
homework,
to
pay
attention
to
the
issues
at
hand
and
to
address
them,
and
so,
at
the
end
of
the
day,
the
question
becomes.
A
Where
do
you
stand
when
history
is
written
on
particular
issues?
Where
will
we
stand
in
terms
of
being
a
legislative
body
that
is
responsible
for
making
very
important,
very
tough
decisions?
Where
will
we
be
on
the
side
of
history
when
it's
all
said
and
done,
and
so
again,
I
just
wanted
to
put
that
out
there
into
the
atmosphere
and
thanking
the
members
for
being
here
and
for
recognizing
that
this
is
something
that's
very
important
and
very,
very
complicated.
A
I,
don't
believe
that
this
bill
is
the
end-all
to
be
all,
but
I
do
think
that
this
will
be
something
that
will
be
helpful
for
what
it
is
that
we
are
trying
to
accomplish,
and
Philadelphia
has
a
massive
problem
with
opioids
and
heroin
use
and
drug
addiction
in
general,
and
anything
that
we
can
do
to
make
a
difference
should
be
done
period.
So
again,
I
just
wanted
to
put
that
out.
There
and
I
wanted
to
thank
the
members
for
being
here
this
morning
and
if
we
could
call
the
first
panel
forward.
A
C
Morning,
chairwoman,
Basten
members
of
the
Public
Health
and
Human
Services
Committee
I'm,
dr.
Carolyn,
Johnson
I,
am
the
deputy
health
commissioner
for
the
city
of
Philadelphia.
Thank
you
for
allowing
me
to
testify
on
bill
number
1808
88,
which
proposes,
which
is
sponsored
by
Councilman
Greenlee
and
chairwoman
bass.
This
bill
proposed
this
to
prohibit
pharmaceutical
companies
sales
representatives
from
giving
gifts
to
doctors
and
would
require
that
companies
submit
to
the
Department
copies
of
printed
materials
that
they
give
to
doctors
during
sales
visits.
C
We
believe
this
bill
will
help
prevent
future
health
problems
in
Philadelphia
caused
by
unnecessary
and
inappropriate
prescribing
of
drugs.
Today's
opioid
crisis
began
with
the
overprescribing
of
prescription
opioid
painkillers
by
physician
and
other
licensed
medical
providers.
While
doctors
are
certainly
to
blame
for
much
of
this
problem,
the
physicians
in
this
country
didn't
independently
decide
to
start
writing
more
prescriptions
for
opioids.
They
did
it
based
on
prompting
of
thousands
of
sales
representatives
from
pharmaceutical
companies
that
sell
opioids.
Many
of
these
sales
representatives
told
medical
providers
that
the
drugs
were
safe
and
non
addictive.
C
The
sales
pitches
were
tragically
effective
as
we're
seeing
now
between
1999
and
2010.
The
sales
of
prescription
opioids
quadrupled
in
this
country,
and
this
has
led
to
tens
of
thousands
of
Philadelphians
addicted
to
opioid
pills,
heroin
and
fentanyl
and
the
christ
that
we
are
experiencing
today
in
homelessness
and
drug
overdoses.
C
Furthermore,
pharmaceutical
manufacturers
have
continued
to
push
opioids
even
up
to
recent
times.
Over
twenty
nine
month
period,
between
August
of
2013
and
December
of
2015.
Pharmaceutical
companies
spent
forty
six
million
dollars
for
gifts
to
physicians
in
the
United
States.
Encouraging
them
to
prescribe
even
more
opioids
to
the
top
drugs
that
were
promoted
were
fentanyl
and
oxycodone,
which
are
among
the
leading
causes
of
drug
overdose
deaths
in
Philadelphia.
But
this
bill
isn't
really
about
managing
the
opioid
crisis.
It's
about
preventing
the
next
drug
crisis,
while
sales
of
prescription
opioids
are
declining
in
Philadelphia.
C
C
One
of
the
key
ways
that
sales
representatives
influence
doctors
prescribing
is
by
giving
them
small
gifts,
especially
meals.
The
gifts
aren't
limited
to
the
doctors
themselves.
The
sales
representatives
also
buy
meals
for
the
doctor's
office
staff,
from
nurses
to
receptionist
in
exchange
for
listening
to
their
sales
pitches.
While
these
gifts
may
seem
harmless,
studies
have
shown
that
they
actually
are
effective.
That's
probably
why
drug
companies
spend
billions
of
dollar
every
year
on
these
marketing,
trinkets
and
meals.
C
In
one
study,
doctors
who
had
received
10
or
more
free
meals
from
opioid
manufacturers
wrote
five
times
as
many
prescriptions
for
opioids
as
those
who
had
not
received
the
same
number
of
meals.
Our
concerns
are
not
just
about
marketing
of
addictive
drugs,
but
rather
all
prescription
drugs,
antibiotics
or
another
example.
Pharmaceutical
companies
have
developed
marketing
materials
specifically
to
counteract
prescribing
guidelines
that
are
issued
by
the
CDC.
At
least.
One
company
has
been
cited
by
the
US
Department
of
Justice
for
making
false
claims
about
its
antibiotics.
C
The
CDC
estimates
that
a
third
of
all
antibiotic
prescription
in
this
country
are
unnecessary
and
that
greatly
increases
the
likelihood
that
dangerous
bacteria
will
become
resistant
to
antibiotics,
which
puts
all
of
us
at
risk
bill
number.
Eighteen,
oh
eight,
eight
eight
would
put
in
place
minimal
regulations
to
limit
the
aggressive
marketing
of
prescription
drugs.
It
would
require
that
Pharma
sales
representatives
register
with
the
Department
of
Public
Health.
It
would
require
that
they
wear
identification
badges
when
they
are
making
sales
calls
and
they
would
submit
all
written
sales
materials
to
the
Health
Department.
C
Most
importantly,
it
would
prohibit
sales
representatives
from
giving
gifts
to
doctors
and
their
staff,
and
the
bill
would
prohibit
farmer
representatives
from
giving
discount
to
pounds
for
addictive
drugs
to
doctors
for
distribution
to
their
patients.
A
discount
coupon
like
that
may
just
be
what
it
takes
to
begin:
a
patient
on
the
road
to
drug
dependence
and
addiction.
It's
important
to
point
out
what
the
bill
does
not
do.
The
bill
would
not
prohibit
or
limit
pharmaceutical
sales
representatives
from
talking
to
doctors
or
other
medical
providers
to
promote
their
drugs.
It
allows
for
educational
tivities.
C
The
bill
would
not
require
that
the
Department
of
Public
Health
approved
their
marketing
materials
before
they're
distributed.
It
just
requires
that
we
receive
a
copy
of
them
to
see
what
drugs
are
being
promoted
and
what
claims
are
being
made
in
the
city
of
Philadelphia
other
cities
and
states
and
institutions
have
taken
similar
action
to
regulate
Pharma
sales
representatives
in
Philadelphia,
the
largest
health
systems,
Temple
Jefferson
and
the
University
of
Pennsylvania
all
have
policies
that
restrict
the
sales
activities
of
former
representatives.
C
C
Patients
in
Philadelphia
should
feel
confident
that
their
doctors
are
making
decisions
based
on
their
best
interests,
not
what
a
Pharma
sales
representative
has
been
advertising
or
potentially
misleading
the
doctors
to
prescribe
this
bill,
along
with
the
administration's
proposed
amendments,
will
help
protect
individual
philadelphians
from
misuse
of
prescription
medications,
and
it
will
help
prevent
the
city
from
experiencing
another
drug
crisis
as
severe
as
today's
opioid
crisis.
Thank
you
very
much
for
the
opportunity
to
testify.
D
Your
last
name
good
morning,
chairwoman
bath
some
members
of
the
committee
again,
my
name
is
Elizabeth
Oquendo
oqu,
andia
and
I
serve
as
a
director
of
conflict
of
interest
in
the
Lewis
Katz
School
of
Medicine
at
Temple
University.
Thank
you
for
the
opportunity
to
testify
today
on
bill,
one
eight,
zero
888
and
its
potential
effect
on
the
temple
health
community.
As
you
may
already
know,
Temple
University
and
Temple
Health
is
uniquely
located
in
the
epicenter
of
Philadelphia's
opioid
crisis.
D
Our
campus
at
Episcopal
Hospital
treats
many
opioid
overdoses
on
a
daily
basis
and
we
have
the
highest
opioid
mortality
rate
in
the
entire
city.
Temple
House
supports
this
bill
because
we
believe
that
a
pharmaceutical
gift
ban
will
help
to
protect
not
just
the
physicians
at
work
at
Temple
health,
but
those
throughout
the
city
from
the
undue
influence
of
pharmaceutical
marketing.
The
Lewis
Katz
School
of
Medicine
implemented
our
own
conflict
of
interest
policy
in
2012,
which
prohibits
faculty
from
accepting
gifts
from
pharmaceutical
companies.
D
This
includes
meals,
travel
and
other
small
transfers
of
values
of
me
familiar
with
trinkets
pens,
notepads
things
like
that,
our
entire
Health
Sciences
Campus
is
gift
free.
We
do
not
allow
pharmaceutical
representatives
to
enter
patient
care
areas
or
market
directly
to
patients.
Pharmaceutical
representatives
have
to
be
accompanied
by
faculty
and
staff
at
all
times.
We
also
do
not
allow
any
giveaways
during
product
demos,
no
free
lunches,
and
we
do
not
allow
our
physicians
to
actually
engage
in
restaurant
talks
in
which
they
market
drugs
or
devices
to
fellow
physicians.
On
behalf
of
pharmaceutical
companies.
D
Apart
from
caring
for
our
patients,
we
also
educate
future
physicians
and
allied
health
professionals
that
will
live
and
work
in
our
communities
and,
to
that
end
we're
sure
that
the
Medical
School
provides
education
to
students
and
trainees
about
conflicts
of
interest
through
their
scientific
integrity
and
ethics
coursework.
We
believe
it's
our
responsibility
to
teach
our
future
health
care
providers
about
the
correlation
between
industry
provided
gifts
and
provider
prescriber
rates.
It's
important
to
note
that
these
types
of
conflicts
of
interest
policies
are
becoming
the
norm
nationwide.
D
We
are
not
the
only
academic,
medical
center
or
health
system
in
our
area
to
embrace
gift
bans
for
physicians,
and
we
believe
that
the
policies
will
help
lessen
pharmaceutical
company
influence
on
physician
prescribing
behavior.
Although
our
policy
holds
our
own
physicians
to
our
conflict
of
interest
policy
and
gift
ban,
many
temple
health
patients
who
come
to
us
with
substance,
use
disorders
and
opioid
overdose
injuries
are
treated
by
community
providers
who
do
not
fall
under
our
own
conflict
of
interest
policies.
D
E
Good
morning,
chairwoman,
bass
and
members
of
the
committee,
my
name
is
David
grandi,
GRA
n
de
I'm
pleased
to
be
here
today
to
support
bill
number
one:
eight,
zero,
eight,
eight,
eight
I'm,
a
physician
and
health
policy
researcher
at
the
University
of
Pennsylvania
and
Penn's
Leonard,
Davis
Institute
of
health
economics
and
have
expertise
on
the
issue
of
pharmaceutical
marketing.
Let
me
quickly
get
to
the
point
this
bill,
as
you've
heard,
does
three
things.
The
first
one
is
require
pharmaceutical
companies
sales
representatives
to
register
with
the
Department
of
Public
Health.
E
The
second
one
is
to
share
their
promotional
materials
with
the
Department,
and
the
third
is
to
prohibit
companies
from
giving
gifts
to
doctors
to
market
their
drugs.
The
first
two
are
simple:
common-sense
steps
to
increase
transparency
of
what
drugs
are
being
marketed
in
our
city
and
how
they're
being
marketed.
However,
I'm
gonna
focus
my
comments
on
that
third
element,
which
is
gifts
and
I,
have
one
message:
gifts
should
have
no
place
in
the
relationship
between
doctors
and
pharmaceutical
companies.
This
legislation
would
eliminate
gifts,
and
my
hope
is
that
the
committee
will
support
it.
E
I'm,
a
primary
care
physician
myself
and
one
of
the
most
important
aspects
of
medical
care
is
trust.
If
you
go
to
your
doctor
feeling
sick
or
anxious
about
your
health.
The
last
thing
you
want
on
your
mind,
is
whether
you
can
trust
your
doctor
when
I
recommend
a
treatment,
my
patients
need
to
be
able
to
trust
that
I'm
acting
in
their
best
interest.
E
Imagine
for
a
moment
if
your
doctor
recommended
a
medication
and
when
you
walked
out
of
the
office,
you
passed
a
pharmaceutical
salesperson
on
the
way
out
caring
in
an
office
lunch
with
promotional
materials
for
the
medication
you
were
just
prescribed,
it
would
at
least
make
you
wonder
our
patients
right
to
be
concerned.
A
large
number
of
studies
show
the
gifts.
Even
small
gifts
can
influence
decisions.
The
federal
government
collects
data
on
gifts
and
payments
to
doctors.
E
Several
studies
linking
that
data
with
actual
physician
prescribing
records
show
that
when
drug
companies
provide
free
meals,
physicians
are
more
likely
to
prescribe
the
marketed
drug
eating
a
free
lunch
while
listening
to
a
pitch
from
a
marketer
changes.
What
you
take
away
from
the
pitch
and
how
you
feel
about
the
product-
and
why
does
all
of
this
matter
when
marketing
fuels
inappropriate
prescribing
of
new
drugs
that
can
create
costs
and
safety
concerns
marketed
drugs
are
more
expensive
and
there's
less
clinical
experience
with
them,
and
that
is
not
to
say
that
new
drugs
are
bad.
E
It's
just
to
say,
we
need
to
be
prescribing
them
only
when
it
is
appropriate.
What
has
brought
this
issue
front
and
center
is
the
concern
about
aggressive
marketing
of
addictive
medications
and
I
can
tell
you
my
own
personal
experience
when
I
started
residency
18
years
ago.
At
that
time,
drug
companies
were
aggressively
marketing,
new
long-acting
pain
medications
like
oxycontin
and
I.
E
Remember,
hearing
that
we
were
not
doing
enough
to
treat
pain
and
while
these
drugs
had
a
place
for
some
patients,
the
messages
from
marketers
were
very
one-sided,
downplaying
risk
of
abuse
and
touting
better
and
safer
pain
control.
In
hindsight,
the
marketers
did
know
more
than
they
were
telling.
They
saw
the
early
warning
signs
of
the
risk
of
abuse
but
continued
to
deliver
a
one-sided
message
to
doctors,
but
it's
not
just
medications
like
opioids.
The
same
story
was
true
for
a
medication.
You
probably
remember
called
Vioxx.
E
It
was
a
prescription
medication
very
similar
to
over-the-counter
advil,
but
a
prescription
medication,
nonetheless,
that
millions
of
people
took
unnecessarily
that
was
fueled
by
aggressive
marketing
to
doctors
only
to
find
out
later
there
were
concerns
about
heart
attack
risks
and
many
of
the
patients
that
took
Vioxx
should
have
never
been
prescribed
it
and
would
not
have
been
on.
It
were
not
for
aggressive
marketing
to
doctors.
E
There
is
nothing
wrong
with
pharmaceutical
companies
sharing
information
about
drugs
with
doctors,
a
free
and
open
conversation
can
be
part
of
sharing,
new
knowledge
and
information,
or
there's
no
reason
why
gifts
should
be
part
of
this
interaction.
Gifts
cloud
judgment
and
a
road
trust,
and
you
may
hear
the
doctors-
are
highly
trained
and
should
be
immune
from
the
effects
of
gifts.
But
doctors
are
people
too,
and
that
is
just
not
true,
and
that
research
backs
this
up,
and
you
may
also
hear
that
industry.
E
Self-Regulation
is
enough,
and
that
is
also
not
true,
as
the
industry's
own
guidelines
allow
the
very
meals
that
have
been
shown
to
influence
decisions,
and
you
have
to
ask
yourself
why
they
would
be
spending
the
money
if
the
gifts
didn't
matter.
Philadelphia
can
take
a
step
forward
today
to
protect
public
health
by
prohibiting
gifts
and
creating
more
transparency
around
the
information
being
delivered
by
marketers
and
I.
Strongly
urge
you
to
support
this
legislation.
A
A
One
of
the
the
arguments
by
the
pharmaceutical
industry
is
that
doctors,
in
terms
of
scheduling
time
with
doctors,
that
the
only
way
to
be
able
to
get
in
front
of
a
doctor
is
to
offer
free
meals
or
something
of
that
sort
which
doesn't
really
make
sense
to
me
and
I'm
wondering
if
you
could,
you
know
what
is
your
opinion
on
that
in
terms
of
doctors
at
Temple
and
Penn,
and
their
scheduling
and
I
know
that
this
is
not
a
practice
that
is
supported
in
those
fine
institutions,
but
just
I.
You
know
it's.
A
E
So
doctors
need
to
eat
lunch,
they
do
eat
at
some
point
during
the
day,
but
it
doesn't
need
to
be
provided
by
a
pharmaceutical
company
and
if
the
information
being
provided
by
pharmaceutical
sales
representatives
is
valuable,
then
doctors
will
make
time
to
hear
it.
If
the
only
reason
why
doctors
wanting
here
the
marketing
is
because
food
is
being
provided,
then
perhaps
we
need
to
question
whether
the
information
being
delivered
is
valuable.
I.
D
A
You
still
have
representatives
that
come
in
on
a
regular
basis,
and
you
know
Temple
and
Penn
are
some
of
the
finest
institutions,
not
just
in
the
city
of
Philadelphia
but
across
the
nation,
and
so
this
has
not
been
a
policy
that
is
hindered
you
all
being
able
to
get
information.
Your
farmers,
your
doctors,
being
able
to
get
information
and
to
appropriately
prescribed
to
their
to
their
patients.
D
F
You,
madam
chair
and
I,
think
that
raises
an
important
point
and
if
I
may
say,
your
opening
comments
were
well
taken
on
everything.
I
do
want
to
point
out
for
the
record,
though,
that
one
of
them
committee,
members,
councilman,
Derek,
Greene,
had
had
informed
us
a
while
ago
of
a
long-standing
commitment
dealing
with
the
issue
of
autism.
G
F
Has
been
very
involved
with
so
yes
and
I
know
he
cares
very
much
about
this
issue,
absolutely
just
a
few
quick
things,
and
it's
more
just
kind
of
emphasizing
some
of
the
things
you
said
dr.,
Johnson,
I'm,
sorry,
I'm
glad
you
pointed
out
that
this
bill
is
just
not
about
the
opioid
crisis.
The
opioid
crisis,
obviously,
is
something
it's
the
impetus,
because
it's
right
out
there
now,
but
there's
the
issue
of
addiction
and
I
think
it's
been
pointed
out
on
some
of
these.
F
C
B
H
F
C
C
E
F
There
was
it
maybe
some
issues
raised
about.
Does
the
department
have
the
capacity
to
handle
this?
Are
you
I
mean
you're
here
so
I
think
I
know
the
answer
right
good.
Just
for
the
record,
you
say:
do
you
have
any
concern
that
the
volume
of
information
it
might
come
in
might
be?
You
know
too
much
for
you
to
handle.
Could
you
talk
about
that?
Well,.
B
C
F
F
C
I
C
F
Thank
you,
I'm
sorry,
I'd
be
real,
quick,
a
couple,
more
questions.
If
I
may
ma'am
chair
just
again,
there
was
a
letter
put
in
and
you
addresses
dr.
Johnson
again
who,
on
your
testimony
that
I
don't
know.
Maybe
the
individual
didn't
really
read
the
bill.
It
talks
about
that.
There
shouldn't
be
pre-approval
of
material
given
out.
There
is
no
pre-approval
of
the
material
in
this
bill,
not.
C
F
And
real,
quick,
miss
Oquendo
I,
see
on
your.
You
obviously
have
read
the
bill
and
in
your
description
of
what
temple
asked
for
this,
your
reservations
even
stronger
than
this
bill
correct
and
you
tell
people
where
they
can
be,
and
all
that
kind
of
thing
correct
and
to
repeat
what
the
question
the
chairwoman
asks:
you've
so
been
able
to
to
function
right
and
people
have
been
able
to
talk
to
each
other
and
there's
been
no
problem
with
that.
F
Carry
and
finally,
dr.
grandi,
you
put
you
you
mentioned
I,
think
a
key
word
in
your
testimony.
You
say
their
patients
are
twice
as
likely
to
report
low
trust
in
their
doctor
and
I
would
guess,
trusting
your
doctors
pretty
important
thing,
and
that's
probably
one
of
the
reasons
you
have
this.
These
regulations
that
you
do,
which
we're
trying
to
put
in
with
the
city
is
that
right,
yeah.
E
I
mean
Trust
is
really
at
the
foundation
of
every
doctor-patient
relationship.
People
come
to
their
doctor
at
a
time
of
vulnerability,
anxiety,
sickness,
and
it
is
not
the
time
to
be
needing
to
go
out
and
ii.
Guess
ii
check
every
single
decision
that
your
doctor
is
making
on
your
behalf
or
recommending
to
you
and
every.
F
That
brings
any
issue
of
perception,
because
I
think
there's
reality
that
there
has
been
pointed
out
in
the
testimony
that
the
number
of
gifts
and
the
number
of
prescriptions
correlate
in
a
lot
of
ways.
But
there's
also
that's
perception
of
both
the
patient
themselves
and
also
the
perception
of
the
general
public
am.
I
is
that
a
fair
statement
that
yeah.
E
J
Morning,
woman
good
morning,
thank
you,
madam
chair
councilman,
bill
Greenlee
was
reading
from
my
notes
because
he
posed
a
number
of
questions
that
I've
wanted
to
ask
as
well.
So
I
need
to
make
sure
I
heard
what
I
think
I
heard.
Are
you
saying
that
there's
no
great
current
registry
for
pharmaceutical
sales,
reps,
that's
maintained
any
place
in
the
city
fall
off?
Is
that
what
I
heard
that.
J
J
J
J
And
then
I
to
ask
about
capacity
always
because
too
often
I
hear
when
we
introduce
measures,
we
hear
from
departments.
Oh,
we
don't
have
the
capacity
particularly
around
lead.
That
would
be
another
health
department
challenge
to
go
ahead
next
year.
So
you
anticipate
receiving
these
marketing
materials
and
then
walk
walk
us
through
what
you
believe.
The
next
steps
will
be
once
you
get
those
materials
and
that's
look
at
the
worst
case
scenario.
C
For
example,
controlled
substances
like
narcotics
and
opioid,
and
those
related
drugs
would
probably
be
categorized
together
to
see
what's
being
marketed
for
those
antibiotics
may
be
bunched
together.
So
my
sense
is
that
a
lot
of
this
will
be
that
we'll
have
to
organize
the
materials,
and
then
there
will
be
some
some
local
review
of
this,
not
that
we
can
change
the
materials,
but
it
is
to
understand.
Well,
these
are
the
drugs
that
are
out
there,
and
this
is
what's
being
said,
and
if
we
see
a
problem
then
we
might
actually.
C
J
J
C
That
is
the
only
we're
not
restricting
if
somebody
wants
to
give
a
coupon
for
a
discount
on
an
anti
hypertensive
medication.
There
are
no
restrictions
on
that.
It's
restrictions
are
only
for
controlled
substances,
and
there
is
one
exception
that
was
added
when
it
was
brought
to
our
attention
that
the
medications
to
treat
opioid
addiction
such
as
suboxone,
which
is
one
that
I
think
you've
all
heard
about
now
that
there
is
an
exception
that
allows
coupons
that
provide
for
those
controlled
substances
that
treat
addiction
to
be
permitted
and.
C
B
J
J
J
C
A
E
E
J
J
The
sponsor
of
the
bill
has
shared
with
me
the
reasoning
on
why
we're
casting
a
net
wide.
What
is
your
view
of
perspective
on
that
when
we're
principally
concerned
about
addictive
drugs
now,
tomorrow
and
forever
and/or
opioid
drugs,
which,
quite
frankly,
was
still
trying
to
figure
out
how
we
can
get
our
arms
around.
C
C
Between
pharmaceutical
representatives
and
the
physicians
and
what
that
exchange
is
so
it
right
now
it
is
there's
no
control
over
the
giving
of
gifts
and
the
influencing
of
opinions
about
all
kinds
of
drugs,
and
you
know
if
it
were.
But
you
know
in
this
city
of
diabetes,
for
example,
is
a
very,
very
common
problem
and
there
are
lots
of
medications
that
are
prescribed
for
diabetes.
It
would
be
equally
unacceptable
to
me
to
have
a
pharmaceutical
representative
giving
misleading
information
about
a
drug
to
treat
diabetes.
It
may
not
end
up
in
addiction
and
homelessness.
Schulich.
A
J
And
then,
lastly,
I
believe
the
mapping
and
how
data
can
drive
policy
decisions
that
this
mapping
have
any
any
role
in
in
this
legislation
or
is
a
too
premature
because
I'm
curious
to
know
if,
if
the
violations
in
the
way
that
we
have
come
to
understand,
them
are
more
prevalent
and
certain
parts
of
the
city
than
others
is?
Is
it
too
premature
to
get
a
handle
on
what
sections
of
the
city
are
more
egregious
if
you
will
and
and
the
practices
that
this
bill
addresses.
C
Well,
it
probably
is
a
little
premature
to
do
that.
We
know
some
of
our
partners
have
came
forward
in
support
of
this
bill,
the
big
universities,
but
we
really
don't
know
what's
going
on
across
the
city
now
I
am
positive,
that
there
are
many
private
practices
in
this
city
that
have
similar
policies
to
this.
They.
J
A
C
A
J
A
E
I
would
just
say
that
I
think
in
my
mind,
the
the
the
prohibition
on
gifts
is
very
straightforward
in
terms
of
how
we
want
to
clean
up
those
relationships.
I
think
this
part
about
our
registry
right
now.
We
wait
to
see
when
problems
emerge.
Spikes
in
prescribing
of
something
and
I
think
what
we
always
want
in
public
health
is
early
indicators
that
we
can
then
act
on
and
I
think
putting
the
department
in
a
position
to
say
maybe
in
one
part
of
the
city
we're
seeing
a
spike
in
the
marketing
of
a
particular
medicine.
E
J
That
may
indeed
be
an
opportunity
if
we
want
to
not
end
up
with
another
crisis
from
crack
to
opioids
and
a
different
kind
of
crisis
X
number
of
years
from
now,
so
the
the
American
Medical
Association
will
keep
the
registry
of
physicians
correct.
So
there's
a
full
awful
chapter
that
keeps
the
registry
of
physician
physicians
in
the
city,
I'm
all
struck
by
the
fact
that
we
don't
have
a
registry
of
pharmaceutical
reps.
Yes,.
E
J
K
Thank
you
good
afternoon
and
thank
you
for
your
work
on
this
I
appreciate
councilman
bass
and
Councilman
Greenlee,
taking
the
lead
on
this
people
assume
that,
because
I
represent
cussin
tend
the
epicenter
of
the
opioid
addiction
that
this
is
not
a
citywide
problem.
So
I
appreciate
what
we
have
broader
discussions
around
this
I
hate
to
be
that's
how
I
get
all
the
time.
I
do
have
a
question
for
the
health
department.
K
You
know
we
always
get
criticized
when
we
try
to
legislate
I
hate
when
industry
comes
in
and
tells
me
I
can't
legislate
because
I've
run
to
legislate.
So
I
always
have
this
debate
when
I'm
getting
Lobby.
Just
like
don't
tell
me
what
I
cannot
do
because
a
bunch
of
people
vote
for
me
to
do
this,
though,
but
I
am
interested
to
know.
What
is
it
that
we
do
with
the
doctors
on
our
payroll
and
funded
by
the
Health
Department
right
now,
as
relates
to
their
relationship
to
the
pharmaceutical
industry,.
F
L
C
That
is
the
policy
by
which
we
have
stood.
It's
policy
I
personally
follow
I'm
sure
my
Commissioner
does.
Although
I
don't
mean
to
speak
for
him,
it
does
not.
We've
never
done
anything
with
registering
pharmaceutical
representatives
or
have
asked
any
of
them
from
marketing
within
our
premises.
This
would
be
a
new,
a
new
thing
that
we
would
have
to
implement
as
well,
but
there
is
no
intention
at
all
to
carve
out
the
Health
Department
as
being
exempt
from
any
of
these
regulations
weeks.
We
expect
to
abide
by
everything
as
written
yeah.
K
Let
me
encourage
us
to
be
more
proactive
than
that.
It's
established
and
protocols,
because
the
one
area
where
I
do
think
it's
important
is
we
can't,
let's
not
ask
the
private
sector
to
do
what
we're
not
willing
to
do
internally
right
and
so
there's
a
lot
of
doctors
on
our
payroll
and
we
need
to
make
sure
that
they
are
if
we
need
again.
K
This
is
all
new
territory
right,
as
we
are
doing
this,
that
that
we
do
this
internally
right,
so
that
when
the
private
sector
says
this
is
too
complicated,
we
can
say
no,
we
do
it
internally,
we
manage
so
many
doctors
and
we
have
a
lot
of
part-time
physicians
in
our
paper.
You
know
who
also
work
for
the
other
industry.
Do
some
time
in
the
city,
so
I
think
it's
important
and
that
helps
shape
right
because
it
very
quick
to
tell
people
what
they
can't
do,
not
always
as
proactive.
K
K
C
You
have
to
fall
into
one
of
the
categories
to
be
eligible
and
you
have
to
get
an
authorization
and
a
card,
but
I
don't
see
that
it
would
be
subject
to
any
of
this
regulation.
That's
not
to
say
that
I,
don't
think
it
should
be
regulated,
I'm,
not
saying
that,
but
because
it
is
not
a
prescription.
Drug
it
is
not
covered
under
here.
Is
that
what
we're
kind
of
struggling
here
is
that
it
hasn't
come
up,
but
I
do
not
think
it's
covered
yeah.
K
So
let
me
encourage
us
to
look
at
that
right,
because
I
know
that
the
pharmacy
pharmaceutical
industry
is
now
getting
into
the
cannabis
business
right
and-
and
they
spend
quite
a
bit
of
time
on
this
discussion
of
everything
you
know
opioids
to
MIT
I'm,
not,
as
you
know,
I'm,
not
a
fan
of.
Why
don't
we
do
it
to
another
opioid
and
that's
why
this
whole
cannabis
piece
interests
me
about
how
this
all
falls
into
place
with
this.
So
from
your
understanding
from
it
from
all
of
you.
K
K
What,
if
anything,
would
in
terms
of
datasets
as
we
develop
this
pharmaceutical
rep
stuff?
How
you?
How
do
you
see
proactively
using
this
information
as
it
relates
to
patterns,
as
as
the
council,
one
was
saying
around
mapping
and
the
reason
I
say
that
is
because
the
DEA
gives
shares
with
my
office
a
lot
of
information
around
pharmacy
and
weights.
Sales
of
pharmacies
and
I
have
some
of
the
highest
opioid
sales
pharmacies
in
the
country
in
the
seventh
Council
Matic
District.
So
there's
a
relationship
there
and
one
of
the
works.
K
C
So
I
think
the
the
we
do
have
access
to
some
of
the
prescribing
data
that
you're
talking
about
through
some
of
the
Medicaid
databases
and
through
some
of
the
private
insurers,
we'll
share
data
with
us,
although
generally
the
data
is
not
named
based
for
the
for
the
patient,
it
will
be
provider
based.
So
we
do
have
an
ability
to
take
a
look
at
the
way
prescribing
patterns
are
occurring
across
the
city
and
based
on
what
populations
they
may
be
serving
as
well
so
I
think
in
the
future.
C
Our
plan
would
be
to
try
to
match
up
that
data
to
see
what
the
marketing
is
doing.
What
the
pharmaceutical
representative
marketing
is
doing,
where
it's,
what
it's
saying,
where
it's
going
against,
what
may
be
showing
up
in
some
of
these
major
databases,
prescribing
patterns
and
I.
Think
if
we
find
I'll,
say
aberrations
or
we
find
that
a
drug
is
being
prescribed
more
than
we
believe
should
be
acceptable.
We
probably
would
investigate
at
least
inquire
of
the
providers.
What's
going
on.
K
Thank
you
again,
anything
that
adds
to
transparency.
You
know
I
always
find
very
difficult
when
people
are
against
us
being
more
transparent
about
what
we're
doing
and
if
you're
gonna
conduct
business
in
the
city
of
Philadelphia
and
we're
City
government,
we
should
have
access
to
the
information,
and
so
thank
you
very
much.
Thank.
M
M
C
M
Mine,
that
is
my
next
question.
What
what
is
what
is
a
definition
of
a
gift?
Consider
Mercedes
Benz
was
a
trip
to
Hawaii.
It
could
be
okay.
No,
we
would
not
I
understand
I
mean
that's,
that's!
That's
a
sizable
gift
to
try
to
sway
someone
right.
That's
might
be
closer
to
the
definition
of
bribery.
I
got
it
yeah,
but
lunches.
M
Where
does
that
end
with
lunches?
I
mean
I.
Think
and
I've
been
a
Salesman
in
many
ways
and
for
a
long
time
different
products,
Chamber
of
Commerce
memberships
being
one
of
them,
but
a
lunch
is
also
a
convenient
way
of
getting
together
with
so
on,
because
as
human
beings,
unless
you
won
on
a
different
mechanism
of
metabolism,
everybody
has
to
eat
at
some
point
sort
of
nice.
M
What
would
your
feeling
be
if
there
was
a
limit
on
that
lunch?
I
mean
I,
can't
believe
that
I
that
a
physician
would
go
against
his
own
wiII,
be
swayed
by
ten
dollar
hoagie,
or
something
like
that.
Small
man
minimal
be
interested
in
hearing
what
you
have
to
say,
I
mean:
is
they
change
their
entire
practice,
because
someone
came
in
with
a
wah,
wah
hoagie
or
thinks
hoagie
or
some
sort
of
hoagie.
E
M
M
E
You
know
I
I,
think
it's
a
mistake
to
think
about
this.
As
you
know,
some
sort
of
bribery
transaction
where
someone
is
saying
I
will
give
you
this
in
exchange
for
you
prescribing
my
medication.
But
when
someone
is
feeding
you
and
they're
delivering
a
marketing
message
to
you,
it
makes
you
more
receptive
I.
M
Think
you
may
have
some
opinions
on
I
have
some
other
opinions?
Oh,
but
I'd
like
to
see
your
data
I
I
would
have
to
say,
though,
in
in
my
and
in
my
eyes
what
you're
buying
if
you're
buying
anything
at
all
is
is
the
person's
time
in
this
sense,
with
look
you
got
to
eat
I
gotta
eat.
Why
don't
we
eat
together?
M
I
mean
unless
they're
bringing
in
things
from
you
know,
Barclays
prime
rib
I
get
that
that's
a
little
over
the
top
or
you
know
Capital
Grille,
that's
over
the
top,
McDonald's
hamburger
or
Wawa
hoagie,
or
something
in
that
nature,
where
it's
a
small
amount
of
dollars
just
to
sit
and
eat
and
talk
to
someone
about
a
product.
I,
don't
see
the
relevancy
of
that.
Well,.
E
Very
intrusive
I
know
it
doesn't
seem
intuitive,
but
the
the
research
shows
that
small
gifts
influence
decision
making
it's
true
for
doctors,
it's
true
for
non
physicians
as
well.
It's
the
very
reason
why,
when
you
receive
little
fundraising
things
in
the
mail
that
have
free
mailing
labels
inside
it
makes
people
more
likely
to
donate
money
because
they've
received
a
gift
and
they
want
to
do
something
in
return.
They.
M
Might
I
mean
okay,
I
mean
the
other.
The
other
question
I
have
is
a
number
of
when
you're
talking
it's
specifically
opioids.
At
this
point,
they're
generic
products
I
mean,
for
example,
morphine
codeine.
You
know
opium
itself,
they're
manufactured
by
a
host
of
manufacturers.
I
believe
correct
me.
If
I'm
wrong.
M
Don't
think
there's
any
I,
don't
think.
There's
any
I
mean
we're
believed
a
drug
sales
person
is
making
lead
would
be
with
something
that
is
not
generic
at
this
point
use
our
product
cause,
it's
better
I.
Think
in
those
cases
oxycontin
yes,
has
been
abused,
but
it
is
still
on
that
list
and
the
fentanyl
I
believe
is
still
there.
Not
generic
drugs
is
my
understanding.
M
This
is
not
really
looking
at
the
at
the
picture
because
they're
generic
drugs,
which
any
salesman
could
have-
and
it
doesn't
matter
I,
don't
think
I
mean
when
I
think
you're
salesman
makes
the
difference
or
a
saleswoman.
It
makes
a
difference
if
it's
a
drug
that
is
specific
to
a
particular
company
and
they're,
the
only
ones
that
make
it
and
we'd
like
you
to
try
this,
because
and
and
and
and
and
once
again
giving
a
big
gift
trip
to
Hawaii
or
someplace
that
yeah.
M
You
know,
I
got
a
problem
with
that,
but
I
I
have
less
of
a
problem
or
no
prom
at
all.
If
it's
really
just
a
minimal
lunch
because
you
need
to
eat,
I
need
to
eat,
let's
eat
together,
I
mean
I,
think
that's
how
this
practice
started.
I,
don't
think
it
actually
started
because
of
anyone
trying
to
be
being
spirited
or
getting
a
leg
up
on
someone.
M
It
was
basically
I'm
taking
you
to
lunch,
not
not
taking
on
so
you're
gonna
eat
in
your
office
and
I'm,
coming
with
a
hope,
I,
don't
see
the
the
reason
that
has
to
be
reported.
In
fact,
III
would
be
in
favor
of
banning
any
kind
of
gifts
in
a
large
way.
It
makes
some
sense,
but
some
of
this
doesn't
make
much
sense
to
me
because
it's
minimal
it's
it's
I,
can't
the
doctor,
man
or
woman
would
put
their
reputation
on
the
line
over
a
hoagie
I.
Don't
think
that
makes
any
sense
anywhere.
I.
E
M
C
C
C
M
I've
talked
to
a
number
of
people
with
number
of
doctors
and
correct
me
if
you
think
I'm
wrong
or
the
information
I'm
about
to
give
is
wrong.
But
a
lot
of
the
patient-doctor
relationship
that
happens
in
this
country
is
at
the
end
of
the
appointment.
When
someone
is
feeling
bad,
they
are
going
to,
they
are
going
to
ask,
or
they
are
expecting
a
prescription
of
some
sort
generally
to
cover
their
pain
or
their
cover
their
ailment
or
make
them
better.
M
M
C
Would
agree
that
many
patients
come
in
with
the
expectation
of
getting
a
prescription
and
I
just
want
to
point
out.
The
bill
doesn't
have
anything
to
do
with
that.
We
really
are
not
trying
to
put
ourselves
between
the
patient
and
their
physician.
That
interaction
is
sacred
to
me
as
the
physician.
What
this
is
bill
is
about
is
putting
the
the
intrusion
between
the
pharmaceutical
rep
and
the
doctor.
It's
the
giving
of
the
gifts,
it's
the
influencing
of
what
that
physician,
ultimately
might
recommend
to
the
patient.
So
we
are.
C
M
A
B
F
H
A
A
G
I
might
I
might
start
chairman
bass,
thank
you
and
members
of
the
Public
Health
and
Human
Services
Committee
I'm
Chris
Milano,
president
and
CEO
of
Life
Sciences
Pennsylvania.
Thank
you
for
allowing
me
to
testify
today
on
bill
number
188,
eight,
eight
in
an
ordinance
entitled
forma
civil
sales
and
marketing
practices,
as
we
all
know
too
well.
The
opioid
epidemic
is
one
of
the
worst
public
health
crises,
the
city
of
Philadelphia,
the
Commonwealth
of
Pennsylvania
and
our
country
have
faced
in
the
past
century.
G
Its
effects
are
far-reaching
and
community
agnostic,
in
fact
I'm
sure
every
one
of
us
in
this
room
has
personally
felt
the
consequences
of
this
ongoing
emergency.
I
want
to
make
it
clear
from
the
outset
that
the
life
sciences,
community
of
Pennsylvania,
is
committed
to
doing
everything
in
its
power
to
curb
this
tragic
epidemic
and
as
a
public
advocacy
organization.
This
issue
has
been
one
of
our
top
priorities
for
several
years.
G
In
discussions
with
legislators
at
the
state
and
federal
levels,
my
colleague,
Miss
Bregg
'nor,
will
speak
in
a
few
moments
about
how
we
as
a
community
and
how
we
as
a
society,
have
reached
this
crisis
I'd.
Like
to
provide
a
local
life
sciences
perspective
on
this
ordinance
as
a
statewide
trade
association,
life
sciences,
Pennsylvania
represents
more
than
800
member
organizations,
including
small
biotech
companies,
pharmaceutical
manufacturers,
academic
research
institutions,
medical
device
makers,
patient
advocacy
organizations
and
myriad
service
providers
related
to
the
development
of
groundbreaking
therapy
and
cures.
G
I'm
pleased
to
report,
a
number
of
our
member
companies
are
working
on
novel,
non
opioid
medications
to
treat
chronic
and
acute
pain,
as
well
as
tamper
resistant
delivery
modalities
for
these
medicines.
In
fact,
one
of
our
top
advocacy
priorities
at
the
federal
level
is
robust
funding
from
the
federal
National
Institutes
of
Health,
the
NIH
of
which
the
Commonwealth
has
two
top
five
recipients,
the
University
of
Pennsylvania
and
the
University
of
Pittsburgh.
G
Earlier
this
year
in
the
bipartisan
Budget
agreement
that
was
passed
by
Congress,
an
additional
five
hundred
million
dollars
was
set
aside
to
support
ongoing
and
new
research
to
address
the
opioid
crisis,
given
Philadelphia's
vast
intellectual
capital
and
entrepreneurial
spirit.
I
would
like
to
note
that
this
is
one
place
where
the
city
and
the
life
sciences
community
can
work
together
to
ensure
Pennsylvania
and
Philadelphia
in
particular,
is
the
place
where
this
crisis
meets
its
demise.
However,
we
have
significant
concerns
about
how
this
ordinance
was
drafted
without
any
consultation
with
our
region's
diverse
life
sciences.
G
Community,
this
ordinance
could
have
a
negative
effect
on
the
perception
of
Philadelphia
as
a
life
sciences.
Hub
discourage
connections
that
are
made
here
between
researchers,
scientists
and
healthcare
providers
and
most
important
have
unintended
consequences
for
patients
all
while
doing
nothing
to
actually
reverse
the
opioid
abuse
epidemic.
As
dr.
Johnson
acknowledged
in
her
testimony
that
the
at
the
end,
the
first
panel
and
I'll
read,
it
was
not.
She
did
not
say
this
was
not
only
about
the
opioid
crisis.
She
very
specifically
said,
but
this
bill
is
not
about
managing
the
opioid
crisis.
G
It
is
about
preventing
the
next
drug
crisis
I'm
here
to
ask
the
committee
to
delay
a
vote
on
this
ordinance
until
subject-matter
experts
from
the
health
care
community
and
from
the
developers
and
manufacturers
of
medicines
have
the
opportunity
to
express
their
perspectives
and
have
meaningful
solutions.
Consider
there
are
approximately
190
190
life
sciences,
organizations
that
call
Philadelphia
home
and,
according
to
a
2016
Greater
Philadelphia
regional
Life
Sciences
report.
More
than
4200
individuals
are
directly
employed
by
life
sciences.
G
Entities
in
the
city
policies
like
the
one
proposed
paint
the
industry
with
a
broad
brush,
require
onerous
and
unnecessary
licensure
requirements,
especially
for
our
small
and
emerging
biopharmaceutical
companies,
and
could
further
inhibit
growth
in
the
life
sciences
sector.
Additionally,
this
ordinance
can
hamper
the
interaction
between
researchers,
pharmaceutical,
medical,
science,
liaisons
and
health
care
providers,
either.
By
lessening
the
likelihood
those
individuals
will
come
to
Philadelphia
for
conventions
and
conferences
or
through
a
ban
on
something
seemingly
trivial,
like
modest
meals,
which
could
interfere
with
these
communications.
G
I
had
to
take
note
of
the
councilman's
comments
about
the
meals
and
the
assistant,
professor
from
from
Penn's
comments
about
the
influence
of
a
lunch
on
a
physician's
prescribing
behavior.
The
the
point
about
trust
really
just
does
not
fit
in
that
I
I
have
to
believe
that
physicians
base
their
prescribing
behaviors
on
what's
right
for
the
patient,
not
on
a
sandwich.
Thank
you
for
that.
Mr.
councilman
healthcare
providers
use
exchanges
with
pharmaceutical
manufacturers
to
gain
valuable,
up-to-date
medical
information
about
of
medicines,
risks
and
benefits.
G
Given
the
intense
time
constraints
under
which
doctors
operate,
meeting
over
a
cup
of
coffee
breakfast
or
a
lunch
can
sometimes
be
the
only
time
in
which
a
physician
or
other
healthcare
practitioners
can
carve
out
time
to
meet
with
a
representative
from
the
developer
and
manufacturer
of
important
medicines,
these
aren't
just
salesmen.
These
are
experts
in
the
medicines
that's
prescribed,
the
doctors
are
prescribing.
G
Furthermore,
the
provision
that
requires
manufacturers
to
submit
all
written
materials
to
the
Department
of
Health
is
of
great
concern
to
our
members
and
something
we
have
heard
about
from
several
companies
and
the
ordinance
does
specifically
say
copies
of
all
written
materials
describing
our
concerning
health
drugs
prior
to
distributing
any
materials
to
healthcare
practitioners.
All
the
point.
F
G
You
and,
as
was
acknowledged,
all
these
company
materials
are
already
reviewed
by
the
FDA
Wow.
Well,
I
appreciate
dr.
Johnson's
comments
about
the
resources
of
the
Department
of
Health.
I
can
assure
you
this
is
a
job.
The
FDA,
with
an
annual
budget
of
five
billion
dollars,
takes
very
seriously
and
it's
unclear
how
the
city
may
determine
what
further
health
care
provider
training
is
required
simply
by
reviewing
sales
materials
that
have
already
been
scrutinized
along
the
same
lines.
G
The
life
sciences
industry
is
committed
to
following
the
highest
ethical
standards
and
complying
with
laws
at
all
level
of
government.
There
is
extensive
compliance
to
ensure
companies
are
operating
in
good
faith
under
the
federal
anti-kickback
statute,
the
federal
Sunshine
Act
and
the
Health
and
Human
Services
offices
using
Office
of
Inspector
General's
federal
compliance
program
for
pharmaceutical
manufacturers,
while
marketing
practices
have
certainly
come
under
scrutiny
in
decades
past.
G
Given
all
the
requirements
that
this
ordinance
puts
forth,
it's
concerning
that
section,
6
1204,
which
gives
the
Board
of
Health
open-ended
authority
to
promulgate
further
regulations
as
they
deem
necessary,
was
also
included
in
this
proposal.
While
we
recognize
that
the
Board
of
Health
must
have
some
flexibility
in
its
ability
to
put
forth
regulations,
it
is
concerning
that
such
a
broad
ordinance
would
give
the
board
further
unlocked
authorization
and
independence
from
city
council
oversight.
G
As
our
concerns
on
many
aspects
of
this
ordinance
have
been
made
clear,
it
must
be
noted
that,
should
legislation
be
enacted,
the
90-day
effective
date
is
simply
impractical.
That's
in
the
current
ordinance,
even
for
our
largest
member
companies.
This
is
an
expedited,
expedited
timeframe
and
one
our
small
to
medium-sized
companies
will
find
particularly
difficult
to
achieve,
but
this
ordinance
affects
more
than
the
interaction
between
physicians
and
the
developers
of
the
medicines
they
prescribe.
G
The
prohibition
on
magnet,
manufacture,
co-pay
assistance,
coke
coupons
on
all
controlled
substances
could
be
financially
harmful
to
patients
as
health,
insurers
and
pharmacy
benefit.
Managers
have
shifted
more
cost
responsibilities
to
patients.
Even
small
changes
to
cost-sharing
requirements
like
this
prohibition
can
adversely
affect
patient
adherence
and
lead
to
increased
health
costs
when
a
disease
is
not
managed
appropriately.
These
coupons
are
not
gifts
to
physicians.
They
are
an
example
of
valuable
assistance
programs
that
help
patients
with
their
costs
so
that
they
can
afford
their
medications.
G
Clearly,
the
unintended
consequences
for
patients
is
exactly
the
kind
of
development
we
want
to
avoid,
and
it's
why
we're
here
today,
Philadelphia
is
home
to
a
life
sciences
community
that
has
been
at
the
forefront
of
medical
breakthroughs
for
centuries.
Most
recently,
the
first
cell
therapy
to
essentially
cure
a
type
of
cancer
was
developed
here
at
Penn
and
first
approved
by
the
FDA
and
the
first
fda-approved
gene
therapy
that
may
prove
to
be
a
cure
for
a
certain
type
of
blindness
was
also
developed
here
in
Philadelphia
at
Children's
Hospital,
and
now
a
company
called
spark
therapeutics.
G
We
have
no
doubt
that
if
elected
officials,
physicians,
industry,
experts,
researchers,
scientists
and
all
those
others
dealing
with
the
opioid
crisis
can
work
together
on
a
policy
solution
benefiting
from
each
other's
expertise,
we
can
assure
Philadelphia
is
a
leader
in
reverse
this
tragic
health
crisis.
I.
Thank
you
again
for
the
opportunity
to
testify.
A
N
You,
madam
chairwoman,
Thank
You
members
of
the
council.
Thank
you
for
allowing
me
to
have
the
opportunity
to
testify
before
the
Philadelphia
City
Council
committee.
My
name
is
sharon
Brickner
I'm,
a
registered
nurse
by
training
license
to
work
in
both
Texas
and
in
Virginia.
I,
recently
worked
in
to
the
emergency
rooms
in
Northern
Virginia,
where
I
live
weekend
shift
every
weekend,
just
to
keep
my
hands
in
to
the
clinical
care.
N
I
also
worked
previously
in
hospice
nursing
in
both
a
facility
and
home
based
care,
very
familiar
with
pain
management
and
the
patients
that
need
medications
in
order
to
live
their
lives.
I
now
work
as
deputy
vice
president
at
Pharma,
the
pharmaceutical
research
and
manufacturers
America
that
represents
30
of
our
leading
biopharmaceutical
companies.
Reese
and
our
companies
are
devoted
to
discovering
new
medicines
that
help
patients
live
longer.
N
Since
2000
Pharma
member
companies
invested
more
than
six
hundred
billion
in
research
for
new
treatments
and
cures,
an
estimated
50
1.2
billion
in
2014
alone,
we
have
really
promising
research
that
offers
new
treatments
and
promising
treatments
on
the
horizons.
In
fact,
we
have
40
new
medicines
in
the
pipeline
to
treat
those
who
are
currently
addicted
to
opioids
and
yet
another
40
new
medicines
in
the
pipeline
too,
for
that
are
non
opioid
alternatives,
which
is
a
nice
alternative,
because
not
everyone
needs
an
opioid,
and
these
are
important
pipeline
medications.
N
N
We
stand
ready
to
be
part
of
that
solution,
along
with
other
stakeholders,
and
we
want
to
be
part
of
this
ordinance
that
provides
policy
tools
to
help
create
meaningful
change.
It's
important
to
step
back
and
look
at
how
we
got
here
with
this
epidemic.
There
are
many
contributing
factors
that
thankfully
no
longer
exist,
but
I
want
to
raise
those
to
give
some
context,
because,
several
years
ago,
with
the
approval
of
opioids,
the
FDA
was
in
its
infancy
approving
products
as
quickly
as
30
to
60
days.
N
Now
we
have
products
that
go
from
bench
to
bedside
that
take
10
to
12
years
or
the
three
lengthy
phases
of
clinical
trials
to
ensure
an
efficacy
and
safety
of
our
medicines.
In
addition,
hospitals
were
being
reimbursed
based
on
pain
scale,
so
patients
were
be.
If
it
were
saying
how
was
my
pain
managed
in
the
hospital
and
if
it
was
managed
well,
they
would
give
a
favorable
rating
and
therefore
with
the
hospital
would
get
better
reimbursement
rates.
N
Also
medications
that
are
highly
effective
in
treating
pain
were
more
addictive
than
previously
understood
and
patients
did
become
quickly
addicted.
There
was
no
plan
of
care
with
the
healthcare
provider
and
the
patient
to
wean
that
patient
off
of
medications
and
the
alternative
strategies
and
products
that
we
have
now
were
not
as
available.
Now
we
had
those
products,
but
for
those
who
think
that
this
ordinance
is
our
magic
bullet,
it
is
not,
and
it
does
little
to
impact
the
opioid
epidemic
and
help
patients
in
Philadelphia
I
have
four
brief
points
to
talk
about.
N
N
This
ordinance
would
hurt
patients,
particularly
those
who
are
already
addicted,
and
rely
upon
medication,
assisted
treatment,
Slyke,
buprenorphine
and
suboxone
to
get
off
of
their
medicines
to
rebut
inaccurate
testimony
provided
earlier
in
panel
1,
the
medication
assisted
therapies
are
included
as
written
as
the
ordinance
is
written,
so
they
would
be
they
would
you
know
the
fact
that
they're
exempted
is
not
accurate.
Pharma
feels
that
this
is
a
barrier
between
patients
and
providers
again
needing
to
rebut
that
important
point.
That
was
made
an
inaccurate
point
in
panel.
N
One
number
two:
the
ordinance
is
misguided
by
requiring
manufacturers
to
submit
their
marketing
materials
to
the
city,
because
our
manufacturers
already
do
this.
We
submit
educational
and
training
and
marketing
materials
to
the
FDA
ordinance
is
unnecessary
and
duplicative
and
would
use
additional
resources
and
expenditures
of
the
city
that
could
be
spent
elsewhere,
and
manufacturers
already
abide
by
this
FDA
requirement.
Third,
this
ordinance
creates
a
meal
ban
which
prevents
manufacturers
from
providing
a
meal
while
conducting
an
educational
briefing.
N
This
is
a
critical
tool
for
manufacturers
to
provide
important
information
to
the
entire
clinical
staff,
as
I
said
I'm
a
nurse.
A
lot
of
these
educational
briefings
are
not
just
intended
for
the
physician
or
the
prescriber,
but
for
the
nurse
who's
actually
giving
and
administering
those
medications
or
teaching
the
patients
how
to
appropriately
use
their
medications
and
adhere
to
those
medicines,
so
they
can
have
better
outcomes
and
lower
health
care
costs.
N
The
uses
for
old
products,
new
uses
that
are
now
proved
for
old
products,
because
they
do
not
have
the
time
to
sit
there
to
read
clinical
journals
to
network
with
colleagues
and
get
the
latest
and
greatest
and
data
they
have
a
very
busy
day.
By
implementing
this
meal
ban,
the
ordinance
would
do
a
real
disservice
to
our
health
care
providers,
which
ultimately
does
hurt
the
patient,
who
may
not
get
that
best
treatment
option
for
their
condition.
If
the
provider
is
unaware
of
the
new
innovative
treatment
option.
Fourth,
we
believe
that
section.
N
Six
12:04
of
the
ordinance
is
overly
broad
and
vague
and
causes
great
concern
with
our
industry.
If
it
passes
as
written,
the
city
could
create
any
regulation
that
it
wanted.
Mr.
Molineux
already
addressed
much
of
that
so
I'm
going
to
move
to
my
final
point,
which
is
that
this
ordinance,
if
it
were
to
pass,
would
mean
that
our
companies
must
have
additional
time
than
what
is
currently
provided
in
that
ordinance.
We'd
asked
to
extend
the
days
from
90
days
to
180
days
or
more
to
ensure
that
the
companies
could
comply
again.
N
These
unnecessary
requirements
take
away
time
that
our
companies
need
to
devote
to
research
and
development
to
new
cures.
Opioid
alternatives,
addiction
treatments,
our
mission,
the
pharmaceutical
industry's
mission
is
to
develop
innovative
products,
and
while
this
ordinance
is
well
intended,
there
are
proven
best
practices
that
the
city
would
incorporate
that
could
better
adopt
and
then
better
address
the
opioid
crisis,
like
seven-day
prescription
limit
for
opioids.
N
Where
mandatory
you
said,
the
prescription,
drug
monitoring
program,
the
PDMP
that
reduces
misuse
and
abuse
without
taking
time
and
resources
away
from
innovation
and
finally,
I
just
wanted
to
mention
another
inaccuracy.
Just
for
Councilwoman
Sanchez,
who
had
asked
about
the
CBD
CBD
oil
has
been
approved
with
one
of
our
medications.
It's
epidural
X,
which
treats
two
rare
forms
of
epilepsy,
so
I
just
wanted
to
make
sure
that
Councilwoman
Sanchez
was
aware
that
this
oil
has
been
approved.
It
would
be
considered
a
controlled
substance
in
London.
Thank
you
for
your
time
and
attention.
H
At
pH
on
Life
Sciences
is
part
of
the
Philadelphia
Convention
and
Visitors
Bureau.
We
work
to
promote
Philadelphia
as
a
thriving
life
sciences
hub
and
a
destination
for
meetings
for
in
life
sciences,
both
large
and
small,
and
certainly
we
know.
The
opioid
crisis
has
net
negatively
impacted
the
lives
of
our
residents,
and
we
want
to
join
you
in
finding
a
solution.
The
tourism
industry
has
been
directly
impacted
by
this
crisis.
We
know
the
rise
in
homelessness
is
in
large
part
due
to
the
opioid
epidemic.
H
It's
the
working
groups
goal
to
make
homelessness,
rare
brief
and
non-recurring
by
addressing
the
root
causes
and
for
many
that
is
opioid
addiction,
and
we
certainly
commend
City
Council
on
taking
the
very
necessary
steps
to
fight
the
growing
epidemic,
and
we
hope
you
will
consider
all
options
before
proceeding
with
this
bill.
The
proposed
legislation
could
profoundly
negatively
impact
the
local
tourism
industry.
In
2017,
we
bought
119
life
sciences,
related
events
to
Philadelphia
that
brought
162
thousand
visitors
to
the
city,
consuming
123
thousand
hotel
room
nights.
H
These
visitors
generated
over
nine
million
dollars
in
state
and
local
taxes
had
an
overall
economic
impact
of
96
million
dollars
in
Philadelphia
Farmar
related
meetings,
both
large
and
small,
in
hotels
and
the
convention
center
make
up
a
large
percentage
of
these
events,
which
provide
opportunities
for
the
work
to
be
provided
for
73,000
hospitality,
jobs
in
the
city,
hospitality
and
tourism
is
now
Philadelphia
and
largest
employment
sector
sector.
Second,
only
to
education
and
looking
ahead
to
future
years.
H
The
life
sciences,
related
events
and
meetings
on
the
books
are
estimated
to
generate
an
impact
of
1.7
billion
dollars
for
Philadelphia.
These
events
provide
significant
job
security
to
local
hospitality
workers,
including
the
residents
who
live
in
every
neighborhood
throughout
this
county.
This
ordinance
would
have
a
significant
negative
impact
on
our
ability
to
both
keep
and
secure
future
biomedical
convention
business.
H
Even
if
the
ordinate
exempts
activities
occurring
on
the
convention
floor,
the
overall
perception
that
our
city
is
not
friendly
to
the
pharma
industry
will
make
us
less
competitive
and
could
hamper
our
ability
to
secure
and
retain
future
business.
Some
currently
booked
conventions
have
already
expressed
deep
concern
that
their
leadership
and
members
will
encourage
organizers
to
consider
other
cities
as
the
convention
destination.
H
If
this
legislation
passes,
all
associations
have
advocacy
platforms
and
carefully
watch
legislation
in
destinations
that
are
contenders
for
future
convention
business
and
when
legislation
is
counterproductive
to
an
associations
legislative
agenda,
it
is
most
certainly
taken
into
consideration
when
deciding
which
destination
to
choose
for
their
next
meeting,
and
we
would
never
condone
the
use
of
travel
as
a
weapon.
In
other
instances,
we
have
seen
associations
make
destinations
decisions
for
their
meetings
and
conventions
based
on
local
legislation.
Today,
meeting
planners
have
such
a
wide
variety
of
choices
when
it
comes
to
choosing
a
city.
H
There
are
a
number
of
variables
they
consider
when
ranking
a
destinations
ability
to
host
an
event
according
to
STRs
destination
map.
A
national
survey
of
meeting
planners
quote
social
political
tension
is
the
seventh
biggest
deterrent,
with
nearly
50
percent,
citing
it
as
a
concern
in
a
destination
selection.
H
Political
tension
sits
closely
behind
more
basic
concerns
like
safety,
cleanliness
and
cost
competition
for
meeting
and
convention
businesses
fierce
we
are
located
between
two
very
successful
life
sciences,
meetings,
destination,
Boston
and
Washington.
Dc
both
have
done
a
great
job
in
building
their
biomedical
communities,
and
we
often
find
ourselves
competing
with
them
directly
among
our
competitive
set,
which
includes
DC
and
Boston.
We
currently
rank
in
the
middle
of
the
pack
on
social
political
tension
with
DC
ranking
considerably
higher
and
Boston
ranking
lower
than
us.
H
In
order
to
retain
our
fair
mac
market
share
of
life
sciences
related
meetings,
we
need
to
keep
our
barriers
to
compete.
Low.
Should
legislation
like
this
pass,
we
won't
have
the
opportunity
to
be
in
consideration
as
a
potential
host
city
for
lucrative
biomedical
meetings
and
conventions
and,
in
addition,
the
amendment
that
addresses
business
on
the
convention
floor.
H
Major
special
events
in
the
city,
like
the
army-navy
game
next
weekend,
where
the
city
used
to
have
to
pay
four
hundred
and
fifty
thousand
dollars
to
host
that
meeting
because
of
the
fills
fund,
they
are
now
only
paying
one
hundred
and
fifty
thousand
dollars
so
conventions
meetings,
large
and
small,
whether
they're
organized
by
the
Philadelphia,
Convention
and
Visitors
Bureau
or
not.
All
of
those
are
important.
The
most
important
point
I
want
to
make
is
with
the
high
caliber
of
this
life
sciences,
meetings
and
conventions
that
we
land
here
in
Philadelphia.
H
We
have
such
an
opportunity
to
capitalize
on
the
fact
that
we
bring
some
of
the
best
minds
in
this
business
together
right
here
in
Philadelphia,
and
we
could
leverage
those
opportunities,
as
Chris
Molineux
has
pointed
out,
to
work
collaboratively
and
develop
a
creative
solution
to
this
epidemic
together,
and
we
welcome
the
opportunity
for
further
discussion
on
s'matter
and
hope
you
will
consider
this
potential
for
lost
business
lost
tax
revenue
and
the
negative
impact
that
bill
one
808,
8
8
poses
on
tourism
and
hospitality.
Thank
you
thank.
I
I
am
the
eastern
director
of
government
relations
for
the
biotechnology
innovational
organization,
which
opens
called
bio
for
the
remainder
of
my
testimony,
because
it's
just
way
too
long
but
anyway,
so
bio
is
the
world's
largest
trade
organization
representing
biotechnology,
companies,
academic
institutions
and
state
biotechnology,
centers
and
related
organizations
across
the
United
States
and
in
more
than
30
other
nations.
I
want
to
start
by
commending
the
council
on
its
desire
to
curb
the
growing
addiction
problem
and
we
at
bio
are
committed
to
working
with
all
stakeholders
and
policymakers
to
address
the
crisis.
I
In
fact,
bio
and
member
companies
have
joined
together
to
identify
ways
in
which
the
biotechnology
industry
can
assist
in
mitigating
the
epidemic
and
address
the
crisis.
Our
activities
have
focused
around
three
key
pillars:
one
advancing
the
understanding
of
the
biology
of
addiction
to
enable
the
development
of
innovative
treatments
for
pain
and
addiction
for
ensuring
those
suffering
from
pain
or
be
able
to
receive
the
right
treatments
and
stimulating
research
and
development
of
innovative
treatments.
So
to
help
prevent
abuse.
The
biopharmaceutical
industry
offers
real
solutions
to
this
devastating
crisis.
I
Emerging
biotechnology
companies
and
established
enterprises
are
working
hard
to
transform
the
standard
of
care
for
pain
and
addiction
through
novel
and
safer
next-generation
therapies.
I
want
to
give
you
a
few
examples
because,
as
we
don't
know
quite
yet,
if
they
will
be
scheduled,
substances
and
disallowing
coupons
for
these
would
also
you
know,
put
a
burden
on
patients
to
have
access
to
these
new
therapies
in
the
city
of
Philadelphia,
for
example,
there's
one
technology,
that's
an
inner
injectable
that
treats
knee
pain
using
capstan,
which
is
actually
a
byproduct
of
Chili
Peppers.
I
There
are
novel
and
stateful
products
for
post
surgical
pain,
control
and
partnering,
with
large
hospital
chains
to
develop,
to
develop
alternative
approaches
to
pain
management.
There
are
also
abuse,
deterrent
formulations
of
think
therapies
that
mitigate
or
prevent
abuse
of
the
therapy.
So
these
novel
and
state-of-the-art
therapies
that
are
the
object
of
the
research
of
our
member
companies
demand
that
companies
help
provide
education
to
healthcare
professionals.
These
educational
interactions
help
healthcare
professionals,
make
informed
decisions
in
consultation
with
their
patients,
based
on
the
most
up-to-date
information.
I
These
interactions
are
held
to
the
highest
ethical
standards
so
that
we
maintain
our
bond
of
trust
with
patients
and
healthcare
providers.
Bio
believes
that
policies
aimed
at
addressing
the
opioid
crisis
should
focus
on
concrete
solutions
to
help
ensure
patients
suffering
from
both
pain
and
addiction
have
access
to
the
most
appropriate
form
of
treatment
across
the
continuum
of
care,
bringing
stakeholders
to
get
from
different
sectors
together.
Focusing
on
these
solutions.
For
these
reasons,
we
believe
policies
such
as
this
proposed
ordinance
may
not
be
appropriately
focused
on
addressing
the
needs
of
individuals
who
suffer
from
addiction.
J
Afternoon,
the
record
should
reflect
that
as
it
and
in
the
interest
of
full
transparency.
I,
remember
the
board
is
full
offices
and
convention
bureau
and
have
expressed
my
concern
on
how
the
bill
would
impact
the
hospitality
and
tourism
industry
and
the
sponsors
of
the
bill
have
heard.
My
concerns
listened
to
my
concerns
and
acted
upon
my
concerns,
which
is
why
the
language
around
hotels,
our
hospital,
the
hospitality
and
tourism
has
been
addressed
and
will
further
be
more
deeply
articulated
in
the
regulations.
So
you
need
to
be
assured
of
that
and.
H
J
Well,
as
the
request
for
the
100,
the
longer
extension
you
we
said
180
up
here,
not
knowing
that
you
have
180
in
your
testimony.
Lastly,
review
briefly
this
this
notion
around
how
coupons
could
still
have
a
negative
effect,
because
that
that
does
trouble
me
the
gentleman
on
the
end.
Whoever
spoke
up
I
think
you
spoke
at
nestle
around.
G
Actually,
Sharon
might
be
better
equipped
to
comment
on
the
problem.
I'm
happy
to
to
reiterate
what
I
said,
and
that
is
that
the
the
coupons
are
designed
to
help
low-income
patients
be
able
to
move
for
their
medications
and
with
with
legislation
as
broad
and
sweeping
as
this
is.
That
would
include
all
medications,
including
medications
that
are
being
used
for
patients
who
are
currently
going
through
rehabilitation,
gradually
being
weaned
off
of
opioids
or
highly
addictive
treatments,
and
unless
that
language
has
changed,
it
would
affect
them
as
well.
Okay,.
G
F
So
it's
a
provision
of
samples
proficient
drug.
This
exemption
shall
not
include
the
provision
of
coupons
for
to
purchase
any
controlled
substance,
and
this
is
the
added
language
unless
it
is
indicated
for
the
treatment
of
substance
abuse
disorder.
Thank
you,
I'm
glad
somebody
said.
Thank
you
eventually.
Thank
you.
A
L
Good
afternoon,
first
of
all,
I
understand
the
council's
grave
concern
with
the
opioid
crisis
and
their
and
their
struggle
to
find
innovative
ways
to
deal
with
it.
I'm
just
concerned
about
the
process
that's
being
followed
in
this
case
I've
I'm,
a
30-year
diabetic.
I
have
worked
a
number
of
years,
including
a
product
liability,
litigation
and
I
think
that
there
it
and
in
the
course
of
that
we
had
to
do
substantial
research
and
congressional
regulation
of
prescription
drugs
and
I'll.
Tell.
G
L
L
If
it's
just
announced
the
other
day
that
Michael
J
Fox
has
funded
the
development
of
a
new
anti
Parkinson
drug.
That
is
immediately
able
to
stop
the
death
of
brain
cells.
There
are
people
out
there
who
are
praying
for
the
quickest
application
of
that
kind
of
technology
and
biological
and
pharmaceutical
advances
as
possible
in
the
diabetes
field.
L
I
started
going
to
an
endocrinologist
about
20
years
ago
and
the
quality
of
care
vastly
improved
there
every
week
there
is
that
they
go
into
market
with
some
brand
new
pharmaceutical,
that
is,
they
are
literally
saving
millions
of
lives.
That's
why
American
health
care
is
the
is
the
envy
of
the
world
so,
and
it's
well
known
now
that
there's
a
very
substantial
political
fight
over
whether
or
not
children
should
be
vaccinated
before
they
go
to
school.
So
there
are
a
number
of
things
that
are
taking
place
with
the
consideration
of
this
ordinance.
L
First
of
all,
as
mr.
Milano
indicated,
the
Food
and
Drug
Administration
does
a
does
a
tremendous
regulatory
job.
The
reason
that
people
can't
get
the
drug
access
to
the
drugs
as
soon
as
they
want
is
because
of
the
very
involved,
very
deliberate,
very
scientific
process
that
they
have
to
go
through
to
make
sure
there
aren't
adverse
impacts.
L
They
also
regulate
the
content
of
the
advertising
and
they
they
have
not
only
five
billion
dollars
in
money,
but
they've
got
the
best
experts
in
the
world
evaluating
and
using
their
judgment
to
determine
how
the
risk
benefit
is
to
be
weighed
in
any
given
case.
So,
what's
what
will
happen
under
this
legislation?
L
First
of
all,
the
whole
idea
that
the
FDA
is
going
to
be
second-guessed
by
city
legislative
bodies
is
going
to
open
the
door
to
groups
like
the
anti-vaccination
people
groups
like
the
anti
birth
control
people,
people
there
are
like
more
than
a
hundred
thousand
municipalities
in
this
country.
So,
instead
of
doing
a
deliberative
scientific
federal
regulatory
process,
Philadelphia
is
going
to
try
to
go
on
record
to
say
every
Township.
Every
borough,
every
municipality
in
America
should
have
its
own
rules
on
prescription
drugs.
That's
a
very
bad
precedent
to
set.
L
And
we
know
people
who
have
been
in
in
public
office
in
Philadelphia
who
experienced
that
kind
of
thing,
whereas
the
introduction
of
some
of
the
new
drugs
that
help
ameliorate,
the
condition
would
do
a
lot
more
to
extend,
extend
life
and
quality
of
life.
So
my
question
is:
if
the
health
Port
Health
Department
of
Philadelphia,
is
looking
to
do
something.
That's
really
useful
for
the
very
many
people
who
need
improve
public
health
care
in
Philadelphia.
L
L
So
how
in
the
world
how
many
staff
people
are
they
going
to
dedicate
to
to
reviewing
drug
inserts
in
these
pharmaceuticals
if
they
wanted
to
do
with
the
deputy
health
commissioner
suggested
they
already
had
the
ability
to
do
it
by
accessing
the
database,
the
Food
and
Drug
Administration.
They
can
look
up
all
the
all
the
information
they
want,
so
that
raises
the
second
question.
L
I
had
a
hard
time
understanding
what
you're
trying
to
do
in
the
section
of
the
bill
that
deals
with
the
filing
of
advertising
and
insert
materials
with
the
city
of
Philadelphia,
because
if
it's
the
intent
of
the
city
to
regulate
it,
then
why
don't
you
say?
So
if
it's,
if
it's
the
it's
the
intent
of
the
city
to
censor
or
edit
those
drug
inserts
say
so,
but
you
don't
really
say
so.
L
First
of
all,
they
negotiate
with
everybody.
Who
knows
anything
about
the
substance
of
the
issue.
They
have
a
hearing
not
for
half
a
day,
but
they
have
hearings
that
consume
many
days
with
the
most
recognized
professional
literature
in
the
field
and
with
the
best
experts
in
the
field
and
with
a
lot
of
technical
support
to
the
legislators
and
over
a
period
of
time,
they
they
make
a
decision.
That
is
scientifically
sound,
we're
moving
to
whether
it's
global
warming
or
whether
it's
vaccinations
we're
now
politicizing
things
that
should
really
be
science.
L
Sometimes
they
accept
those
and
they
give
them
out
to
constituents.
I,
don't
know
whether
you've
stopped
to
think
for
a
second
that
what
you're
saying
is
that
you
believe
that
a
cup
of
coffee
corrupts
somebody,
and
yet
there
are
many
people
and
council
who
own
their
financial
forms,
indicate
the
houses
of
dollars
of
gifts.
So
if
that
is
in
fact,
your
belief,
I
think
you
have
no
choice
but
to
amend
the
ethics
legislation
to
do
what
the
mayor's
actually
done
to
four-zone
appointees,
to
say
that
no
city,
elected
official
can
accept
one
dollar
and
gifts.
L
I
think
that's
an
appropriate
action
to
try
to
say
that
about
the
doctors
and
the
slander
doctors
like
that,
while
saying
we
as
council
people,
you
know
we're
able
to
make
decisions
about
sports
stadiums
and
issues
that
affect
these
groups
and
the
fact
that
we
got
free
tickets
and
free
dinner
doesn't
affect
our
judgment.
It
is
just
hypocritical
and
it's
and
it's
a
further
example
of
the
rush
to
judgment
here
that
things
are
being
amended
for
today's
meeting.
Has
the
testimony
proceeds?
So
what
does
that
mean?
L
That
means
you
haven't
done
enough
homework
to
be
able
to
understand
this
issue
and
to
not
be
in
the
position
that
so
often
happens
with
council
Matic
legislation
that
you
got
a
rush
to
try
to
fix
something
after
after
the
cows
out
of
the
barn
door.
I
think,
based
on
the
testimony
that's
been
presented
here
today
and
I.
Think
the
members
of
this
committee
are
particularly
thoughtful
and
I
think
they
really
do
strive
to
do
the
right
thing
that
the
right
thing
is
not
just
to
try
to
bully
through
or
strong-arm
a
decision
today.
L
The
right
thing
to
do
is
to
take
note
of
a
lot
of
the
facts
that
have
been
presented
in
the
testimony
and
to
do
a
period
of
postponement
and
to
consult
with
people
who
we
know
from
experience
the
impact
that
this
can
have
on
all
sorts
of
patients
and
all
sorts
of
people,
and
you
know
I,
don't
think
it's
a
question
of
dollars
or
tourism
or
any
of
that.
I.
Think
that
in
this
area,
we're
trying
to
weigh
what
is
the
best
medical
care
and
what
is
the
best
health
impact.
L
We
can
have
an
individual's
health
and
the
focus
you've
had
like
blinders
on,
like
horses,
looking
at
the
opioid
problem
and
I,
don't
think
there's
been
consideration
of
the
chronic
disease
problem
and
at
the
life-saving
impact
of
many
of
these
pharmaceuticals
on
so
many
philadelphians
and
I.
Think
that
really
you
should
step
back
and
consider
that
impact.
Thank
you.
A
F
A
F
You,
madam
chair,
may
I
just
add
very
quickly
that,
as
we
have
been
when
we
were
discussing
this
bill
before
today,
we're
always
open
to
talking
with
people
and
hearing
ideas,
and
even
if
we
eventually
council
move
this
bill,
we
can
certainly
keep
our
our
doors
open
and
keep
discussion,
and
if
we
have
to
make
any
changes.
Thank
you,
madam
chair
I,
moved
that
the
amendments
that
were
presented
to
this
bill
be
approved.
A
It's
been
moved
and
properly
seconded
that
the
amendment
just
circulated
and
adopt
be
adopted.
All
those
in
favor
of
the
amendment
signify
by
saying
aye,
aye,
nay
opposed.
Okay,
now
chair,
recognizes
councilman
bill
greenling
for
a
motion
on
bill
number,
one:
eight
zero,
eight,
eight
eight
as
amended.
Thank.
F
A
Been
moved
and
second
and
properly
seconded
that
bill
number
one:
eight
zero,
eight
eight
eight
as
amended,
be
reported
from
this
committee
with
a
favorable
recommendation
and
further
move
that
the
rules
of
council
be
suspended
to
permit
first
reading
of
this
bill
at
the
next
session
of
council.
All
of
those
in
favor
will
signify
by
saying
aye
aye
any
opposed.
Okay,
we
have
one
in
the
opposition,
the
eyes
have
it,
and
the
motion
carries
in
bill
number
one.
A
Eight
zero
888,
as
amended,
will
be
reported
from
this
committee
with
a
favorable
recommendation,
with
a
request
that
the
rules
of
council
be
suspended
to
permit
first
reading
at
the
next
session
of
council.
This
concludes
the
public
meeting
of
the
Committee
on
Public
Health
and
Human
Services,
and
there
being
no
further
business
before
this
committee.
Thank
you
all
very
much
for
your
attendance.