It’s a week of catch up at PostScript – here’s a little link-love before the weekend hits:

A great opinion column appeared in yesterday’s Eugene Register-Guard. The author Gail Hacker M.D., medical director at Lane Community College Health Clinic, does an eloquent job of explaining why drug samples aren’t a solution for her and her underserved patients – and why she feels it’s incumbent on her fellow physicians to turn back pharma’s advances, not the other way around. She writes:

Physicians can afford office supplies and food. Physicians can read journals to get unbiased updates on medications. And if physicians choose to get medical information from a representative of a pharmaceutical company, they can certainly do so without being fed.

Former drug rep talks to docs to Beantown

As we posted earlier this week, former Eli Lilly rep Shahram Ahari was in town talking to medical students and trainees at Boston University, Harvard, Tufts, and Mass General Hospital.  Joe Shortsleeve of WBZ-TV reported on one of his talks and legislation in Massachusetts that would ban gifts to doctors. Watch here.

Congressional clips

Cleveland Plain-Dealer columnist Diane Suchetka takes a look at the proposed federal academic detailing initiative in Congress right now, and talks about the bill with RxP member Allan Coukell, who testified about the practice before the Senate this month.

Coukell also spoke with Pharma Executive about the Physician Payments Sunshine Act, which has been introduced in both houses of Congress.

Business Journal features chief of UMass

John O’Brien, president and CEO of UMass Memorial Medical Center in Worcester, penned this column in the Worcester Business Journal about the process his medical center used to build new, top-tier confict-of-interest policies.

Aussies, AMSA, and Academe

Pharmalot’s been busy, as usual. Here are some recent posts that caught our eye:

Australian Rx is spending big bucks on doctors, too 

AMSA’s how-to on holding pharm-free meetings and conferences

Two MIT researchers’ big idea for restructuring the drug pipeline

Lit review: a false positive?

UC Davis Professor of Medicine Michael Wilkes has this caveat emptor in the Sacramento Bee for those trying to make sense of recent study that found antidepressants little better than placebos in most cases.  Wilkes reads the PLoS Medicine paper as both a case study and cautionary tale about how much we – patients, doctors, even journal editors -  can trust ‘the literature’ in a scientific culture where pharmaceutical companies own the studies and the data they produce.

“Even the process of getting research published in a major medical journal is subject to bias,” Wilkes writes.  “For example, in one recent report, 8 percent of research with a negative result was published in medical journals, compared with 97 percent of research with a positive result.”

This education brought to you by Merck: OK with IOM?

This article from Medical Marketing & Media says the Institute on Medicine is halfway through its slate of meetings on commercial funding of CME, and reports that attitudes on the committee against industry CME may be thawing, but warns that “conflict hawks” like the Josiah Macy Foundation and the Association of American Medical Colleges could still change the status quo.

Well, the RxP Weekly Reader is back and ready for a busy year of news and comment on pharma and medical conflicts of interest. But there’s a few things that happened at the end of the last one that need mention before we dive fully into 2008…

UMass Medical Center clamps down on industry ties

UMass Memorial Medical Center (UMMMC) just introduced tough conflict-of-interest policies to limit industry influence on faculty working at the Worcester campus.

The new rules, which the Prescription Project helped the medical center develop, prohibit faculty from accepting all gifts, including vendor-bought meals on and off-campus, from participating in speaker’s bureaus for industry, and from serving on the hospital’s P&T committee if they have a financial relationship with a drug or device company.  The policies are being lauded as some of the toughest in the nation.

Read more in the Boston Globe, Medical Marketing and Media, Health Care Renewal, and this editorial in the Springfield Republican.   To read more about the Project’s recommendations for academic medical centers, go here.

Alms for the poor, but samples?

Not so much. That’s the contention, at least, of a forthcoming study by researchers at Harvard Medical School and Cambridge Health Alliance, who found that the overwhelming majority of free samples go instead to wealthy or insured patients.

The study, based on a survey of 33,000 Americans, found that just 28 percent of those who reported receiving samples from their physician were poor, and only 18 percent were uninsured for part of the year, statistics that work against the myth that samples primarily aid poor or underinsured patients. The study will be published in the February edition of the American Journal of Public Health.

Read more at USA Today, The Boston Globe, Modern Healthcare (subscription required), Prescription Access Litigation blog and Kaiser Daily Health Policy Report.

“The Cost of Pushing Pills” in PLoS

This analysis in PLoS Medicine uses a new source of industry data to estimate that pharmaceutical companies spend twice as much on marketing as they do on research and development.  The metric, which combines data from IMS Health and research group CAM, is bolder than previous numbers compiled from IMS data that have also suggested that when it comes to pills, the free pen is mightier than the pipette.

In this week’s American Medical News, there’s an excellent ethics opinion piece on physician disclosure and whether it would solve conflicts of interest in medicine.  A researcher and physician each take their turn; one argues that voluntary physician disclosure of gifts to patients would improve patient confidence; the other says disclosure is a false fix for a plainly unethical practice, and anyone who does accept gifts is a “compromised healer.”

District Court strikes down Maine’s data-mining law

As newsrooms emptied and shopping malls filled before Christmas, Bangor district court judge John Woodcock struck down that state’s law, which permitted physicians to opt-out of their prescribing records being sold for marketing purposes.  Despite the timing, here’s copy in the Bangor Daily News and the Wall Street Journal.  And RxP director Rob Restuccia talks to iHealthbeat about the practice.

Next week, the U.S. Court of Appeals in Boston will hear New Hampshire’s appeal of an earlier district court ruling that struck down its prescription data-mining ban in April 2007.

DSM disclosure dismal, says U.S News and World Report

U.S News and World Report takes a closer look at the disclosure ordered up for members of the current DSM update panel – and found less-than-rosy results.  All but eight of the 27 panel members charged with writing the manual that defines what’s a mental health disease and what’s not have financial ties to the pharmaceutical industry, and the news journal found disclosure of those relationships vague and incomplete, despite the APA’s claim that they are a great marker of transparency. Thanks to Pharmalot for the tip.

Miscellany Rx

The Grey Lady finally digested the survey on medical professionalism released in the Annals of Internal Medicine in early December and has this to say about physician professionalism and its bearing on cost and quality.

And here’s the latest on activists taking on the FDA over Provenge, after the regulatory agency flip-flopped on approval of the prostate-cancer drug by Dendreon.  Advocate groups, some of which accept pharma money and others that do not, claim that some of the dissenting advisory board members had conflicts of interest, including a lead investigator on a competitor drug to Provenge.