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Archive for July, 2012

Five-Star Review: Conflict of Interest Webcast by Dr. Eric Campbell

Friday, July 27th, 2012

The National Physician’s Alliance recently held a National Grand Rounds at the University of Connecticut School of Medicine. The presentation, “Understanding Emerging Trends in Industry-Academic Relationships” was given by Eric G. Campbell, PhD, Associate Professor of Medicine at Harvard Medical School and Director of Research at the Mongan Institute for Health Policy.

Dr. Campbell’s presentation is an excellent overview of academic-industry relationships and how they can affect patient care, medical education, and the process and outcomes of biomedical research. He also addresses the role of organizational culture in promoting patient safety in in-patient care.

And, not only is Dr. Campbell a respected sociologist and researcher with more than 50 peer-reviewed publications in journals including the New England Journal of Medicine and the Journal of the American Medical Association, but his presentation style is wonderfully accessible and engaging.

Dr. Campbell starts his presentation by saying his goal in life is to provide people who make decisions about health care with data that can inform the decisions they make. He says he has a “‘crazy belief’ that organizational decisions and laws and policies should be based on research rather than anecdote and allegation, or beliefs about things that ultimately turn out to be completely untrue.” It’s hard to argue with that.

The presentation is certainly worthwhile for anyone in senior policymaking capacities, but also highly recommended for all doctors, nurses, residents and medical students who are interested in understanding what is going on in their work and educational environment.

Dr. Campbell describes what got him interested in studying academic-industry relationships—he was working on his PhD and his advisor recommended he look for somebody behaving in a way that he didn’t understand. For Dr. Campbell, who was teaching anatomy in the medical school at the time, there was free food available in conference rooms around the hospital, available to anyone wearing scrubs. He didn’t understand this behavior: Why was all that free food being made available?

What follows is a terrific analysis of the benefits and risks of academic-industry relationships. Dr. Campbell covers marketing relationships, research relationships, samples, and more. After discussing the risks and benefits, he also goes through a series of myth-busters that clarify his points and further summarize the evidence.

We invite you to view and share the webcast of his presentation, and let us know what you think!

–Anna Dunbar-Hester, Policy Analyst

The National Grand Rounds series by the National Physician’s Alliance, as well as Community Catalyst’s role in the Partnership to Advance Conflict-Free Medical Education, is made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin.

Affordable Care Act Ruled Constitutional, Protecting Patients and Bringing Sunshine

Wednesday, July 18th, 2012

On June 28, the Supreme Court made its momentous decision upholding the Affordable Care Act, a major win in the effort to ensure that all Americans can go to a doctor when they get sick and receive high-quality, affordable care. The ruling paved the way for the law to be fully implemented to benefit the American people. It means that insurance companies can no longer deny care to people when they get sick or if they have a pre-existing condition, benefit expansions such as closing the Medicare prescription drug “donut hole” for seniors and people with disabilities are secure, and new coverage programs for those without insurance can be implemented.

And the decision means many other innovations and consumer protections in the ACA will go forward, including the Physician Payment Sunshine provisions, which Community Catalyst, the Pew Prescription Project and others have championed for many years. The Sunshine provisions mandate that all payments to physicians and teaching hospitals made by makers of drugs, medical devices and biological products be reported to the government, and then disclosed to the public. This broad transparency program is intended to improve quality of care by reducing the incidence of fraudulent or unethical promotions to prescribers and the resulting wasteful costs to patients and public programs.

Fraudulent and highly unethical industry payments to medical professionals have led to lawsuits against virtually every major drug and device company. Just this month, a new record-breaking settlement of $3 billion with Glaxo-Smith-Kline revealed that GSK salespeople paid or compensated doctors through illegal kickbacks related to seven different drugs: Avandia, Paxil, Wellbutrin, Imitrex, Lotronex, Flovent and Valtrex.

“GSK’s sales force bribed physicians to prescribe GSK products using every imaginable form of high priced entertainment, from Hawaiian vacations to paying doctors millions of dollars to go on speaking tours to a European pheasant hunt to tickets to Madonna concerts, and this is just to name a few,” said Carmen M. Ortiz, U.S. Attorney in Massachusetts.

This is fresh on the heels of last month’s shocking revelations about Abbott’s payments to professionals at nursing homes to promote the over-use of Depakote to treat the elderly.

Congress included the Sunshine provisions in the ACA out of concern for such practices and their impact on patient care and medical professionalism. Now industry will be required to report all payments made to doctors and teaching hospitals on a public website. This will allow patients, researchers, Medicare, Medicaid, private health plans, medical schools and academic medical centers can continually monitor these financial exchanges and evaluate whether they could be leading to bias in prescribing or medical education.

Now that the Sunshine provisions are clearly the law of the land, the Obama administration should finalize the regulations promptly so that industry reporting and public disclosure can proceed.

 – Marcia Hams, Director, Prescription Access and Quality