Tuesday, November 27, 2007

What's Sauce for the Goose...

I must say that the Pioneer Press has some pretty good ink-stained wretches scribbling away. A recent insightful article deals with the medical device industry in Minnesota and what we used to call payola. In our state payola is now of public record in the pharmaceutical industry, why not for medical devices?

From the Pioneer Press:

Minnesota is tough on the pharmaceutical industry when it comes to reporting financial relationships between companies and doctors. It's a different story when it comes to the homegrown medical device industry.

As a matter of law, drug companies must disclose to the state Board of Pharmacy payments in excess of $100 that they make to physicians for research or consulting work. But the statute doesn't, in general, apply to medical device manufacturers.

The focus on drug companies prompted an official with New York-based Pfizer Inc. to pointedly ask during a health policy forum this month in Minneapolis: "How can you defend that logically?"

One audience member got a laugh with his explanation: Minnesota is home to a lot of device companies.

But as questions about payments from medical device companies to doctors swirl this fall, manufacturers here are nervous that state lawmakers again will take up the transparency topic. The worry is that public reports about the money given to particular doctors could lead physicians to opt out of consulting arrangements that are vital to the development of medical devices.

"Certain kinds of transparency are good for our society, as well as patients," said Don Gerhardt, the chief executive officer of LifeScience Alley, a St. Louis Park-based trade group for medical device companies. "However, there are kinds of transparency ... that could be detrimental to the development of improved technology."

When the state law requiring pharmaceutical company disclosures was passed back in 1993, payments from device companies to doctors weren't on the radar screen, said Matt Entenza, a former DFL leader in the Minnesota House of Representatives who helped draft the bill.

At the time, Entenza was working in the office of former attorney general Skip Humphrey and was involved in several health care litigation cases involving drug companies. Those cases suggested that doctors were receiving thousands of dollars worth of free trips and gifts from pharmaceutical manufacturers that did nothing to improve care, but helped companies make sure that expensive name-brand drugs were being prescribed, Entenza said.

"We had a lot of information about the huge dollar amounts going to doctors from pharmaceutical companies," said Entenza, who is the board chair and founder of Minnesota 2020, a public policy group in St. Paul. "We did not look at device companies."

This fall, however, there's been a spurt of interest in device company payments.

Sen. Charles Grassley, R-Iowa, introduced a bill that would require disclosure of payments to physicians from both drug and device manufacturers. Grassley asserted that "patients shouldn't be in the dark about whether their doctors are getting money from drug and device makers."

With all the questions swirling, the topic surfaced earlier this month when experts gathered in Minneapolis for the 28th Minnesota Health Care Roundtable, a biannual conference on health care policy. The topic for the day: "Doctors and Drug Companies: Is medical advice for sale?"

Just over halfway through the event, John Swen, a Pfizer vice president, asked why Minnesota required transparency from drug companies, but not other interested parties such as device manufacturers, health plans and others with financial interests in the health care products selected by physicians.

Maybe the U of M should add medical devices to their conflict of interest docket?

Ciao, Bonzo