Industry-physician conflicts of interest continue to be probed

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Sen. Chuck Grassley, R-Iowa, has recently reinforced his crusade to inquire into potential conflicts of interest between industry and physicians. Concurrently, the state of New Jersey has issued recommendations, placing the burden of disclosure of industry payments on physicians.

Grassley, who is the ranking member of the Senate Finance Committee, sent letters to 33 medical groups—including the American Medical Association, the American Diabetes Association, the American Dietetic Association and the American Heart Association—requesting that the organizations reveal industry funding. In the letter, he noted that for the past three years the committee has been looking into various aspects of the pharmaceutical industry, including consulting arrangements and industry funding for Continuing Medical Education.

He requested that the organizations “assist” in his efforts “by providing additional insights into these relationships as well as any changes in transparency that your organization may be planning for in the future. Operating with transparency sends a message that there is nothing to hide.”

As a result, Grassley requested an accounting of industry funding that pharmaceutical, medical device companies, or foundations established by these companies or the insurance industry have provided to these medical societies and associations. He also requested a detailed explanation of all industry funding, including how much money is given to group executives, from January 2006 to the present, to be submitted by Dec. 21.

“These organizations have a lot of influence over public policy, and people rely on their leadership.  There’s a strong case for disclosure and the accountability that results,” Grassley said.

Meanwhile, New Jersey became the latest state to propose recommendations for their physicians to disclose any funding that is received. N.J. Attorney General Anne Milgram recommended banning doctors licensed in the state from accepting gifts that do not directly benefit their patients, and requiring them to report consulting fees greater than $200.

The recommendations noted that “even gifts of nominal value, including food, have an impact on physician prescribing practices,” adding that “gifts are improper and can create influences that do not serve patients’ interests.”

However, Milgram exempted the practice of distributing pharmaceutical samples from the restrictions. The recommendations noted that retail value of drug samples distributed in the U.S. was more than $18 billion in 2005, but are perceived by “patients to be both a convenience and a cost savings.” Also, the recommendations stated the precedent set by Vermont, Minnesota, Maine, and most recently Massachusetts, which expressly exempted samples from the ban on gifts and do not require that their value be included when calculating threshold amounts.

The N.J. recommendations are subject to further review, and it could take six months or more to be reviewed by the Board of Medical Examiners.

Back on Capitol Hill, Grassley also is working for passage of reform legislation he has sponsored with Sen. Herb Kohl, D-Wis. Their Physician Payments Sunshine Act would require annual public reporting by drug, device and biologic manufacturers of payments made to physicians nationwide.

Meanwhile, the National Institutes of Health is working on new disclosure guidelines for federal grant recipients.

“Letting the sun shine in and making information public is basic to building people’s confidence in medical research, education and the practice of medicine,” Grassley said.