RxP Weekly Reader #7
A market research survey of 180,000 docs conducted in the fourth quarter of 2007 found that 19 percent of responding physicians said they refused to see drug reps, no matter what. That sounds like good news, until you get to the part where 73 percent will see a detailer “at any time of day, any day of the week.” But give that the survey conductor, SK& A Information Services, is a healthcare marketing firm, we can’t blame them for some spin. [Disclaimer: this short article does not make clear what percentage of the 180,000 docs called responded.]
Such data may have played a role in this: PhRMA, the trade association for American pharmaceutical manufacturers, says it’s taking another look at its sales and marketing tactics. The trade association has taken some flak for its 2002 *voluntary* code of ethics, which was widely heralded by the medical community as a little better than no code at all.
Sen. Herb Kohl (D-WI), a co-sponsor of the Physician Payments Sunshine Act, sounded a bit skeptical about what such discussions might lead to.
“I would be pleased if the pharmaceutical industry seriously strengthened their self limitations,” Kohl told the AP. “However, if their voluntary approach hasn’t worked over the past six years, I’m unsure whether it would work now.”
In the other house of Congress, Rep. Henry Waxman announced that in his digging he’s discovered a meeting the pharma representatives had with the FDA in April that led to the FDA’s guidance that would allow sales reps to show doctors journal articles on off-label use as part of their pitch. Waxman leaked that in November, and we’re keen to see what comes of this latest development.
State of the States
Tomorrow, the New York State Assembly hears three bills on pharmaceutical reform: one would require public disclosure of gifts from pharmaceutical companies to prescribers, another would prevent companies from selling prescriber data without his/her consent, and a third would create a mandatory state clinical trials registry housed at DHS. RxP, AARP, NLARX, National Physicians Alliance and others will be testifying in support – we’ll keep you posted.
And yesterday, the New York Times ran this damning piece about how the top-tier spinal implant researchers are also top-circle investors in the companies of devices they are researching. As for the rest, you probably know it already…(since this story is on top of most e-mailed at nytimes.com). If not, read this.
A triad of good editorials appeared recently in (chronological order) the Grand Forks Herald (registration required), Beloit Daily News, and the St. Cloud Times, concerning the recent news that a group of Minnesota and Wisconsin hospitals and clinics were shipping their pharma freebies (and conflicts) off to Cameroon. The St. Cloud Times specifically cites the Physician Payments Sunshine Act as a measure worth consideration to curb the marketing influence pharma currently wields over medicine.
This piece from the Barre Montpelier Times-Argus looks how some of the state’s mental health advocacy groups are swearing off pharma, and how much salt one should take with reports like Mental Health America’s annual depression and suicide state ranking (Cheer up Utah!), once the backer (Wyeth) is factored into to the picture.
“The mantra in Vermont and the United States that this is unrestricted money is a myth,” Ken Libertoff told the Times-Argus. “It really has distorted treatment and advocacy in the field.”
Libertoff runs the Vermont Association for Mental Health, which forewent pharmaceutical grants last year. He said he’d begun to feel that accepting the industry backing was changing the nature of his organization’s advocacy work. Wisconsin isn’t doing so hot when it comes to following up or following through on medical complaints. Just eight percent of medical complaints filed between 2002 and 2006 were acted on by the board of medical licensure.
Scrutiny of such investigations has been growing, perhaps in the wake of a New York Times report last May that documented a Minnesota psychiatrist who’d been repeatedly sanctioned by the medical board continued to consult for pharmaceutical companies.
Academy bristles at OIG report
And in a follow-up to last week’s article on the OIG report that the NIH has taken a hands-off approach to monitoring conflicts of interest, the Chronicle of Higher Education takes its turn. With a definite dog in this fight (since the NIH has said universities should police their own grantees), the Chronicle doesn’t pull punches when it comes the research monolith in Bethesda. “In harmony with its distaste for the police function,” the Chronicle writes, “NIH takes a minimalist approach to checking on conflict of interest among its grantees — so minimalist, that any less would be none.” Ouch.
From the blogs:
Here is Howard Brody’s attempt to keep his argument against conflicts of interest on track, and why it’s not akin to hating capitalism….Just in case you were confused.
At the Carlat Psychiatry Blog, Dr. Carlat has an email exchange with American Journal of Psychiatry editor Dr. Robert Freedman that leaves him baffled. Us too. First, Freedman disclosed an unpaid relationship with investigators, then in an email to Carlat, said it was just in case he had to contact pharmaceutical investigators…in the future. Is that like the Boy Scout Motto for conflicts of interest? 10 yards, 10 years: a modest proposal
And what would Superbowl week without a football-related pharma story? After all, PostScript is headquartered in Patriot Nation. So in the spirit of all that side-effect-induced suspense between downs, this Boston Globe column suggests we take the next decade off the pharma ads during sports programming.