Mesh Medical Device News Desk, August 24, 2016 ~ Financial Conflicts of Interest, an ongoing concern in medicine.
Drug and Device Makers Pay Docs with Discipline Disputes
This story is from ProPublica, Journalism in the Public Interest and published yesterday. National Public Radio’s Shots blog also published the story.
When a doctor harms a patient, it is often reported and the doctor is sanctioned by the state medical board. For example, when a doctor overcharges Medicaid for unnecessary or fraudulently marketed devices, or sexually abuses a patient or unnecessarily prescribes addictive drugs, the state medical boards often hear about it and take action.
But that has not stopped medical drug and device makers from rewarding these doctors financially.
Stryker, a medical device maker is cited. ProPublica found it paid one doctor $14,000 in consulting fees even though he was fined by the New York Board for Professional Medical Conduct for improperly prescribing pain meds. Another doctor in San Francisco also was on the receiving end of Stryker dollars even though California’s medical board disciplined him for having a sexual relationship with a female patient.
ProPublica reviewed doctor’s disciplinary records in five states and looked at compensation for speaking, consulting, travel and gifts. Meals were not included since that can happen in a casual setting and does not mean there is a formal relationship between company and doctor.
Altogether 2,300 docs with a history of misconduct were receiving industry payments between August 2013 and December 2015. After another expose by ProPublica in 2010, companies such as J&J, Pfizer and AstraZeneca vowed to revise their screening process for doctors destined to receive payments. Read the rest of the story on ProPublica here.
Mesh News Desk reported in July 2014 about Dr. Andrew L. Brill, MD a gynecologist who was slated to appear on the FDA’s expert panel on morcellator medical devices. An FDA review caught the conflict that Dr. Bill had received consulting fees from the very device makers he was set to review. He was disinvited from the panel. However, Dr. Andrew Brill did appear as an expert panelist on the FDA’s gathering that discussed the future and safety of surgical pelvic mesh in September 2011. The device maker was Johnson & Johnson, the maker of pelvic mesh devices that is facing more lawsuits than any of six others involved in litigation. Read the MND July 2014 story here.
Ed Silverman is one of your editor’s favorite reporters with a breezy style yet spot on accuracy. He used to publish Pharmalot until one day it suddenly disappeared along with all of its archives! That is unusual and led me to wonder if he had rubbed some Big Pharma the wrong way.
Regardless, Silverman is now with STAT, Reporting from the Frontiers of Health and Medicine, where he continues Pharmalot. See today’s here.
Silverman reports on a new study published last week in BioMed Central that finds many experts who assemble guidelines for medical treatment also have financial ties to drug makers.
Altogether 28 different treatment guidelines were examined along with 400 financial conflicts of interest (FCOI) statements issued by 350 authors. Among them, 75% of the disclosures at least one author had such a relationship. In 21%, all of the authors had conflicting relationships.
In half of the guidelines, at least one author had a conflict with the drug manufacturer.
A conflict of interest is defined as financial compensation, gifts, payments and/or reimbursements of some type.
What difference do FCOIs make? Doesn’t it serve to advance science when industry can access real-world experiences by doctors in the field, so essential to innovation?
No really. Maybe it’s just a good coincidence but past experience shows that the presence of payments taints medical decisions, usually in favor of the device or drug maker. Cases cited here, a schizopohrenia and depression study and cardiovascular treatment guidelines – in both cases financial conflicts resulted in overwhelming leaning toward the industry POV.
“This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by medical associations, we encourage them to develop formal policies to limit the potential influence of FCOI on guideline recommendations.”
Read the rest of the story on STAT.