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Medical Experts Want Crackdown On Drugmaker Money

Tue, 04/28/2009 - 7:54am
MATTHEW PERRONE AP Business Writer WASHINGTON (AP) — Millions of dollars in gifts, travel and consulting fees from the pharmaceutical industry should be eliminated to stop companies from influencing how doctors practice medicine, a report by the government's top medical advisers says. The sweeping recommendations from the Institute of Medicine call on medical professionals — from university professors to family doctors — to shun financial arrangements with companies that have flourished over the past three decades. Taking free lunches from company salespeople, giving paid lectures on their behalf and other practices "erode public trust while providing no meaningful benefits to patients or society," institute panel chair Dr. Bernard Lo said in a statement. The report calls on medical schools, hospitals and physician groups to: — publicly report funding they receive from companies. — not accept free meals, gifts or other items from companies. — prohibit doctors who have a financial conflicts of interest from testing new therapies on people. The 353-page document arrives as state and federal lawmakers bolster efforts to require companies to publicly report the money they spend courting physicians. The report could give them more leverage in their push to untangle the knotty relationships between industry and physicians, which some say drive up the cost of medicine. The American Medical Association and other groups have taken some steps in that direction, for instance, phasing out company-paid trips to luxury resorts. And Stanford University, the University of Pennsylvania and other medical schools are disclosing more about faculty members' conflicts of interest. But consumer advocates say more dramatic changes are still needed. "I think there may be some sparks that fly from this report, since many industry and medical groups had already been moving in this direction," said Steven Findlay of Consumers Union. "But I think this will accelerate the movement towards full disclosure of these conflicts." The IOM advises the federal government on health care matters. While its recommendations are not binding, many universities and research groups are likely to heed the advice to avoid scrutiny from lawmakers. In the last year, Sen. Charles Grassley, R-Iowa, has uncovered more than a half-dozen questionable arrangements between leading researchers and drug companies. In one case, the chairman of Emory University's psychiatric department was removed after failing to report hundreds of thousands of dollars in payments from a company whose drugs he was studying. The head of Stanford University's psychiatry department stepped down after similar payments came to light. Grassley and Sen. Herb Kohl, D-Wis., are pushing a bill that would require companies to disclose all payments to physicians over $100. But the IOM report goes even further, calling for the disclosure of payments to patient groups and other nonprofits that are often funded by industry dollars. The Pharmaceutical Research and Manufacturers of America trade group has tried to head off such requirements by reining in marketing efforts. Earlier this year the group asked members to voluntarily stop handing out mugs, pens and other freebies in doctor's offices, though modest lunches and textbooks are still allowed. Nearly all the largest drugmakers are members. Executive Vice President Diane Bieri cautioned about the unintended consequences of adopting the institute's recommendations. "Reports such as this can have far-reaching effects," said Bieri, who is also the group's general counsel. "And when they admit in the report itself that they don't have a lot of data to support these recommendations, we have to be aware of the negative effect they could have." Perhaps the most vigorously defended practice is company support for so-called continuing medical education conferences, where doctors learn about the latest treatments. Most state medical boards require physicians to attend a certain number of hours of education each year to maintain their licenses. The world's largest drugmaker, Pfizer Inc., said in a statement Monday that such education "improves health care provider understanding of disease." While the panel stopped short of calling for a ban on industry-funded education, it stated that "a new system of funding ... should be developed that is free of industry influence." Industry's share of funding for medical education has swelled from 34 to 48 percent in the last 10 years, according to IOM. Opponents of the practice argue that physicians need to pay their way more often. "Lots of professions pay for their own education — for example, lawyers," said Allan Coukell of the Pew Prescription Project. But medical specialists argue they are responsible for keeping up with more information than those in other professions. "The acceleration of science is going to make it tougher and tougher for physicians, nurses and other health care professionals to stay current," said Dr. Jack Lewin, President of the American College of Cardiology.

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