Twenty Billion Dollars A Year
for gifts and payments to doctors from the medical industry?
The Pioneer Press has reprinted an editorial from the the Wisconsin Journal Sentinel. Here it is in all its glory - read it and weep.
The medical industry has 20 billion reasons to expect cooperation from doctors in marketing its products. That's how many dollars the industry spends each year in payments and gifts, according to Senate estimates.
The practice should be banned outright, but for now, we'll settle for full disclosure, which a Senate bill introduced in 2007 by Sens. Herb Kohl (D-Wis.) and Chuck Grassley (R-Iowa) would require.
The Physicians Payments Sunshine Act, which the senators say they will reintroduce within days, would require makers of drugs and medical devices to disclose payments they make to physicians. The payments would be available for review online through the U.S. Department of Health and Human Services.
The Journal Sentinel's John Fauber described a favored tactic in his series "Side Effects," which was published last week:
A prominent university physician comes to town to educate local doctors about a drug. Using slides prepared by the drug company, the speaker does what the drug company cannot: talks about off-label prescribing — using the drug for purposes for which it was not originally designed. While not unethical, Fauber reports, such prescribing often has no scientific evidence to support it.
At the end of the night, everybody goes home happy. The drug companies believe they have a chance to sell more drugs. The speaker is often paid as much as a few thousand dollars. The local doctors get a convivial dinner with drinks.
But most patients don't have a clue about these connections. And the practice likely increases the cost of medicine and certainly calls into question the credibility of some university research.
Deans of the UW Medical School and the Medical College of Wisconsin say they want to tighten up their conflict-of-interest policies, and they should do all they can. But universities have their own conflicts. Allowing outside work might mean they can afford to pay their docs less. And no single university can afford to risk losing top talent by unilaterally cutting off a source of income.
Congress is the best venue to look for solutions, and the Kohl-Grassley bill is a good place to start.
-- The Milwaukee Journal Sentinel
Nice title for the proposed legislation. Sunshine is the best disinfectant. Maybe the U and Mayo won't have to do anything about laughable conflict of interest policies? Senators Kohl and Grassley will take care of the problems for them.