ACC top brass discuss Senate probe, industrys role in cardiovascular care

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ACC CEO Dr. Jack Lewin and ACC President Dr. W. Douglas Weaver. Image Source: American College of Cardiology (ACC)  
While there needs to be improved transparency concerning the financial relationships between physicians, associations and the medical device and pharmaceutical industry, those entities can also play an important developmental and fiscal role in improving cardiovascular care, according to Jack Lewin, MD, and Douglas Weaver, MD, CEO and president, respectively, of the American College of Cardiology (ACC).

Recently, Sen. Herb Kohl, D-Wis., chairman of the Senate Special Committee on Aging, sent a letter to Weaver, requesting information about the college’s five-year partnership with the Cardiovascular Research Foundation (CRF).

In explaining the nature of its relationship with CRF, Lewin told Cardiovascular Business News that the ACC contracted CRF to provide “a whole array of services” for the four-year-old i2 Summit for interventional cardiologists that runs in parallel to the annual ACC scientific sessions.

Last year, ACC formed a partnership—not a contract—with the Society for Cardiovascular Angiography and Interventions (SCAI), which “is a relatively small, but friendly, segment of our network,” according to Lewin. After this year’s ACC meeting in Chicago, SCAI and ACC parted ways. “SCAI decided to take their meeting out of our huge venue to something more intimate. They felt that they got swallowed up and we parted as friends,” he explained.

In vetting other associations to fill SCAI’s role, ACC chose CRF to provide services for the i2 Summit. “We know that there are people, even with our college, that maintain long-standing vendettas against the CRF’s leaders. However, we thoroughly examined their association, and our board unanimously voted to choose CRF,” Lewin said.

Weaver added that while they suspect someone from within ACC complained to the Senate committee about conflicts of interest, no individual has openly come forth to pose their concerns about the contract. Lewin even speculated that the person who complained could be disgruntled due to terminated contracts that went to CRF this year. Lewin said: “I suspect that either self interest or a personal vendetta against officers at CRF is at the root of the complaint.”

However, he stressed that the meeting still belongs to the college and its members. “While we welcome industry’s participation with exposition and educational grants, the meeting is not gong to be driven by industry. The content of the 2009 meeting will be determined by the college, and meet all of our ethical standards,” Lewin noted.

“When we sat down and explained the nature of our relationship with CRF to Senator Kohl, we believe [that the committee’s] concerns were allayed,” Weaver told Cardiovascular Business News.

Lewin acknowledged that the college did not receive any formal written or verbal notification from the Senate committee, but the college execs believe that the matter has ended. He added that in these processes, “almost no one gets a conclusion letter. However, Senator Kohl’s staff and I have talked about it on a number of occasions, and they seem very satisfied with our clarifications.”

Weaver and Lewin also said that the college has openly supported the work of Kohl, along with Sen. Charles Grassely, R-Iowa, and Rep. Bart Stupak, D-Mich., in their pursuit for increased transparency in the various fields of medicine, in particular, with the Physicians Payments Sunshine Act of 2008.

Weaver said that the college thinks the push toward transparency is “all positive.” He said that Eli Lilly’s decision Wednesday to publicly disclose their financial relationships exemplifies the effort, adding that its arbitrary decision to report any contribution more than $500 is representative of what could be a nationwide policy if the Sunshine bill passes through Congress.

However, Lewin did not wish to disregard the potentially positive collaboration between industry and cardiovascular care. “We’re in a situation where the federal government, despite all its good intentions, is really going to be struggling to come up with resources, especially with the current Wall Street crisis. We need the investments of industry—both pharma and device manufacturers,” he said. He added that industry’s influence needs to be managed, so “they are not driving the agenda or biasing scientific publications, education or quality-of-care activities.”

Lewin said that industry ought to be able to contribute to unbiased efforts, as opposed to its other forms of contribution—direct to consumer advertisements that he said does not offer as much value.

“The healthcare sector has been the economic engine for this country for the past eight years…and I think most people could see the advantage of managing conflict with allowing industry to contribute in a constructive way. It would be a shame that we walked away from this opportunity because we can’t manage this type of conflict,” Lewin concluded.