|
E-mail this page to a friend!
Senior Citizen Politics
Aging Committee Chair’s National Registry of Drug
Company Gifts to Docs Creates a Storm
Proposal by Senators Kohl, McCaskill catch media’s
attention
 July
2, 2007 – It was not a hearing that initially grabbed the headlines but
the repercussions continue to grow. Senate Special Committee on Aging
Chairman Herb Kohl (D-WI) held a hearing last week to examine the
pharmaceutical industry’s costly practice of providing payments and
gifts to doctors, and to consider what kind of influence this wields
over some of the nation’s physicians. He announced he will propose a
national registry to require disclosure of payments and gifts, and this
caught the media’s attention. Committee member Sen. Claire McCaskill
(D-Mo.) said she will join with Kohl.
(See KaiserNework.org
reports below on media reactions.)
It is estimated these companies spend $19 billion
annually on doctors in the form of lecture honoraria, conference
registration fees, research grants, trips, meals, drug samples, and
other freebies.
Although this has often been cited as a problem, a
study published in the New England Journal of Medicine earlier this year
reported that 94 percent of physicians have received such gifts and
payments from drug companies. Many were surprised.
“The financial ties between doctors and drug
companies are only deepening,” said Chairman Kohl. “These gifts and
payments can compromise physicians’ medical judgment by putting their
financial interest ahead of the welfare of their patients.”
“While there are voluntary guidelines already in
place, it is clear they are not being followed. I intend to vigorously
pursue stronger adherence to these guidelines, as well as propose a
national registry to require disclosure of payments and gifts.
“We need transparency, at the minimum and at the
outset. Many of these gifts are not illegal, but we need them
disclosed. These interactions involving things of value between the
pharmaceutical industry and doctors must be made public.”
The pharmaceutical industry is considered one of
the most profitable industries in the world, returning more than 15
percent on investments. At the same time, Americans pay the highest
drug prices in the world, forcing some employers to drop health coverage
for employees, squeezing the budgets of state and federal government,
and ultimately harming senior citizens by putting drug costs out of
their reach, says a nrew release from Sen. Kohl’s office.
Speakers at the hearing
included:
Dr. Jerome Kassirer,
a professor at Tufts University School of Medicine and author of On the
Take: How Medicine's Complicity with Big Business Can Endanger Your
Health, provided an overview during his testimony of the various
financial incentives pharmaceutical companies use to influence the
prescribing patterns of physicians.
Dr. Greg Rosenthal,
a retinal eye specialist from Toledo, Ohio, reported to the committee on
the influence-peddling he has witnessed within his specialty, and how
the increasing prevalence of these conflicts of interest led him to
become a founding member of Physicians for Clinical Responsibility.
Dr. Peter Lurie,
Deputy Director of Public Citizen’s Health Research Group, offered the
results of a study he coauthored for the Journal of the American Medical
Association examining state disclosure laws of drug industry payments to
physicians. Lurie also gave his opinion on the creation of a national
registry for the disclosure of all gifts and payments from the drug
industry to doctors.
Maine State Rep.
Sharon Treat, Executive Director of the National Legislative
Association on Prescription Drug Prices, discussed efforts made by
states to limit the influence of pharmaceutical companies. In addition,
Treat discussed the American Medical Association’s (AMA) practice of
collecting and selling information about which drugs doctors are
prescribing to their patients.
Representatives from
both the AMA and Pharmaceutical Research and Manufacturers of America (PhRMA),
the drug industry’s trade organization, offered testimony during the
second panel about their self-imposed voluntary guidelines on both
accepting and giving gifts, and whether they believe there has been a
positive change in this practice since the guidelines were written in
2002.
Dr. Robert Sade,
Chair of AMA’s Council on Ethical and Judicial Affairs, testified on
behalf of the AMA, while Marjorie Powell, Senior Assistant
General Counsel, testified on behalf of PhRMA.
Chairman Kohl declared in his opening statement
that he will continue oversight of the relationship between doctors and
the drug industry.
>>
For links to the testimony and a video of the hearing, click here.
KaiserNetwork.org
Pharmaceutical Industry Should
Not Oppose Registry of Gifts to Physicians, Editorial States
"It's no surprise that the pharmaceutical industry
is appalled at proposals to set up a national registry of its gifts and
payments to doctors" because access to such "information might lead
patients to suspect that their doctors are choosing costly medicines out
of gratitude to the manufacturers rather than for the best medical or
economic interests of their patients," a
New York Times editorial states.
Voluntary guidelines adopted by medical societies
and the
Pharmaceutical
Research and Manufacturers of America "are supposed to limit
payments and gifts to modest proportions," but "they typically still
allow doctors to be paid as consultants or speakers, leaving plenty of
room to lavish favors upon them," according to the editorial.
Senate Special
Committee on Aging Chair Herb Kohl (D-Wis.) and Sen. Claire
McCaskill (D-Mo.) last week
announced
that they "would push for a national registry that would force drug and
medical device companies to report their gifts and payments to
physicians," the editorial states, adding that their proposal "ought to
require electronic reporting of all payments to individual doctors for
posting in a registry that could be easily searched from home
computers." The editorial concludes, "If there is nothing wrong with
such payments, neither the doctors nor the industry should object to
public disclosure" (New
York Times, 7/2).
Letters
The
Times
on Monday also published two letters to the editor written in response
to a June 27 article on a
study
conducted by the state of Vermont that found psychiatrists in the state
receive more payments from pharmaceutical companies than other medical
specialists. Summaries appear below.
● Paul Packman: "The payments you describe are
not gifts but payments for work: consultations, teaching, educational
roundtables and so on," Packman, former president of the
American Academy of
Clinical Psychiatrists, writes in a letter to the editor of
the
Times. "These payments do not differ from those
received by any other type of consultant or educators," Packman writes,
adding, "It is not surprising that the content of these educational
endeavors focuses on the newer, more efficacious medications with fewer
side effects than drugs that have been on the market for 37 years"
(Packman,
New
York Times, 7/2).
● Carolyn Robinowitz/Robert Pierattini: "We do
take exception to your assessment that a 'pattern has emerged' in which
'psychiatrists earn more money from drug makers than doctors in any
other specialty,'" Robinowitz, president of the
American
Psychiatric Association, and Pierattini, president of the
Vermont Psychiatric
Association, write in a letter to the editor of the
Times.
"Vermont's report wasn't about all psychiatrists;
it made claims about only 11, and they were anything but representative
of all of the state's psychiatrists," Robinowitz and Pierattini write.
They add that APA and VPA "are working with state policymakers to
strengthen state tracking laws, for only then can a proper assessment be
made of such payments' influence" (Robinowitz/Pierattini,
New
York Times, 7/2).
Editor’s Note: On June 27, the day of the
hearing, KaiserNetwork.org looked at what other newspapers were saying
about the pharmaceutical company gifts to physicians.
Newspapers Examine Pharmaceutical
Companies' Influence on Physicians
Summaries of the articles appear below.
Gifts: Psychiatrists in Vermont earn more
money from pharmaceutical companies than other medical specialists,
according to a report released on Tuesday by the state, the
New York Times
reports. Vermont identified the top 100 paid specialists in the state,
finding 11 psychiatrists and five endocrinologists in the group.
The state found that payments to psychiatrists more
than doubled from an average of $20,835 in 2005 to $45,692 in 2006.
Endocrinologists earned the second highest amount from drug companies at
an average of $33,730 in 2006. Researchers also found that psychiatrists
who earn the most from drug companies prescribe atypical antipsychotic
drugs off-label to children most often.
A similar pattern was found in Minnesota, where
psychiatrists earn more from drug companies than other physicians and
prescribe more antipsychotic drugs to children. The findings "have
helped to fuel a growing interest among state and federal officials to
document and restrict payments to doctors from drug makers," according
to the Times (Harris, New York Times, 6/27).
Continuing medical education: Pharmaceutical
companies in 2005 paid for about half of the $2.25 billion annual cost
of continuing medical education courses that physicians must take to
maintain their medical licenses, the
Washington Post
reports. Data show that drug and medical device makers pay for about
two-thirds of the cost of courses sponsored by prestigious medical
schools.
Critics say that the rise of
pharmaceutical-sponsored CME courses "raises health care costs, skews
doctors' treatment decisions and allows the industry to skirt laws
against advertising 'off-label' uses for its products," according to the
Post.
Senate Special
Committee on Aging Chair Herb Kohl (D-Wis.) said, "It appears
that everyone profits from this pervasive system of gifts and payments,
except the consumer."
However, Scott Lassman, senior assistant general
counsel for the
Pharmaceutical
Research and Manufacturers of America, said that
pharmaceutical sponsorship of CME courses allows physicians to learn
about the latest medical and scientific research. He added that the
courses "are viewed as running independently of the pharmaceutical
company. The company may be providing the funding for it, but they are
not directing the content." The Senate committee will meet Wednesday to
discuss the issue (Williamson/Lee, Washington Post, 6/27).
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
