Eli Lilly and Company appreciates the opportunity to respond to the editorial “Four Reasons Our Office is Pharma-Free” [Opinion, March/April 2009]. We were moved to respond because we believe we are working with the authors and your readers toward the same goal of excellence in patient care. The solution is not closing a medical practice's doors to companies that deliver to patients life-saving medicines and to prescribers key information related to the use of those medicines. Instead, we invite open dialogue and a forum that supports the exchange of information to ultimately benefit patients who depend on the latest advances in care.

Our first priority is consistently delivering improved outcomes for individual patients – achieved through innovation and information. The pharmaceutical industry's investment in research and development is four times greater than its spending on marketing and promotion,^1,2 not half as much, as suggested by the study the authors referenced. We know it will cost us more than $1 billion to develop every new medicine that reaches a patient, but we're willing to invest in helping patients live better, more productive and longer lives.

Further, as patient care becomes more individualized, we will be called to provide value, not just medicines. That's why we've transformed our marketing practices to focus on providing health care professionals with educational and scientific information. Samples in doctors' offices are another means of delivering value to patients and health care providers. They enable treatment to begin without delay or out-of-pocket cost and enable all patients to try several options when starting new therapies.

We, too, are committed to directing patients to affordable and effective treatments. Our patient assistance programs helped more than 173,000 patients obtain free Lilly products valued at more than $252 million in 2008. Another program not mentioned by the authors is the Partnership for Prescription Assistance (http://www.pparx.org), a program that offers about 2,500 brand and generic medicines, supported by the pharmaceutical industry's trade association, generic manufacturers, health care providers, patient advocacy organizations, community groups and professional medical associations, including the American Academy of Family Physicians.

We believe greater transparency and open communication are the best ways to establish trust with health care practitioners. The greatest benefit for patients and practices depends on the latest advances in care, and this can only come from open exchange, not closed doors.