In the Interest of Patients

How often are physicians "influenced" by their financial relationships with pharmaceutical, biotechnology, or medical device companies? Are they "prescribing under the influence?" Or, do they have enough common sense to be objective and practice evidence-based medicine even if they have financial relationships with industry?

The AAMC has released a report titled, "In the Interest of Patients: Recommendations for Physician Financial Relationships and Clinical Decision Making."

This new report by the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that manage financial relationships between physicians and industry so they do not influence patient care. "In the Interest of Patients: Recommendations for Physician Financial Relationships and Clinical Decision Making" provides guidance on how academic medical centers can identify, evaluate, and disclose conflicts of interest in clinical care.

You can access the report here: http://www.aamc.org/clinicalcoi

The AAMC also published a report in 2008 titled, “Industry Funding of Medical Education: Report of an AAMC Task Force.”  Meanwhile, the Physician Payment Sunshine Act will certainly lead to a greater level of transparency regarding the financial relationships between physicians and industry. Will it be enough?

CMSS Code for Interactions with Industry

The Council of Medical Specialty Societies (CMSS) represents 32 medical professional societies. This roughly translates to a membership of over 650,000 U.S. physicians.

Last month, the CMSS released the CMSS Code of Interaction with Industry. This voluntary code calls for independent and transparent interactions between medical specialty organizations and industry.

Here's a snippet from the April 21 press release:

“CMSS is committed to encouraging and supporting a culture of integrity, voluntary self-regulation and transparency,” said Dr. James Scully, CMSS President and CEO of the American Psychiatric Association.  “This code provides a clear benchmark for maintaining integrity and independence.”

Click here (PDF) to view the CMSS Code of Interaction with Industry.

Docs To Disclose Monies From Pharma

We knew this was coming. Two years ago, Senators Charles Grassley, R-Iowa, and Herb Kohl, D-Wis introduced the bill. To some physicians, this may seem like sunlight shining into a dark alley. For others, it may feel like the sun is melting everything away.

The Physician Payments Sunshine Act requires companies to begin recording any physician payments that are worth more than $10 in 2012 and to report them on March 31, 2013. That includes stock options, research grants, knickknacks, consulting fees and travel to medical conferences at chi-chi hotels. The details will be posted in a searchable database starting Sept. 30, 2013.

To learn, read the full story here on NPR.

Pharmaceutical Industry Raises Drug Prices by 9%

According to this story on the NY Times, Professor Schondelmeyer found that prices for the name-brand drugs most widely used by the Medicare population rose by 9.3 percent in the last year. Professor Stephen W. Schondelmeyer is a pharmaceutical economics professor at the University of Minnesota.

We know that it costs billions of dollars to research and develop a drug. Those costs are not trivial. We also know that the pharmaceutical industry is a for-profit industry and certain compounds end up being very profitable. Where is the balance? How do we ensure that new drugs are being discovered and that patients are receiving adequate and affordable treatment?

AstraZeneca Expands AZ&Me Prescription Savings Program

During these difficult economic times, any type of savings program is appreciated. AstraZeneca is expanding its prescription savings program by extending assistance to qualifying patients who have recently lost their jobs, had their incomes reduced, or experienced a change in marital status or family size.

"AstraZeneca is committed to helping patients get the medicines they need," said Rich Fante, US President, AstraZeneca Pharmaceuticals LP. "Our responsibility goes beyond developing medicines to also making them available to those who cannot afford them."

Here are the details of the AZ&Me(TM) Prescription Savings programs:

• AZ&Me(TM) Prescription Savings program for people without insurance: AstraZeneca provides AstraZeneca medicines at no cost to qualifying individuals without prescription drug coverage who make up to $30,000 per year and families of four who make up to $60,000 per year.
• AZ&Me(TM) Prescription Savings program for people with Medicare Part D: AstraZeneca provides low-cost AstraZeneca medicines for qualifying Medicare Part D patients who make up to $30,000 per year or couples who make up to $40,000 per year.
• AZ&Me(TM) Prescription Savings program for healthcare facilities: AstraZeneca provides AstraZeneca medicines at no cost to qualifying non-profit healthcare facilities, such as disproportionate share hospitals, community health centers and community free clinics. This program connects patients to the AstraZeneca medicines they need at the same time and place they receive their treatment.

Patients can learn more about the AZ&Me(TM) Prescription Savings program at www.azandme.com or by calling 1-800-AZandMe.

AMA on Ethics and CME

The CME (Continuing Medical Education) industry has gone through some significant changes over the last several years. Have you been keeping up with all the changes?

The American Medical Association (AMA) Council on Ethical and Judicial Affairs (CEJA) recently released a report titled, "Financial Relationships with Industry in Continuing Medical Education." This report outlines the ethics of industry supported education - according to the Council on Ethical and Judicial Affairs (CEJA).

Please note that advisory report will be up for consideration at the AMA's upcoming annual House of Delegates meeting. This report is not necessarily the AMA's take/perspective/position on ethics and CME.

Here's the bottom line from the CEJA report:

• It is ethically preferable to accept funding only from non-commercial supporters (this would probably mean that doctors would have to pay for their CME credits).
• It is ethically permissible to accept funding from commercial supporters (such as pharmaceutical companies, biotech, medical device, etc.). This generally leads to free CME.
  

The world of medicine is constantly changing and physicians need every opportunity to keep up with the latest clinical development. If they have to pay for CME, will they be less inclined to learn? Does the abundant supply of free CME cause physicians to practice evidence-based medicine? How does free CME impact patient outcomes?

IOM

The IOM has recently come out with some recommendations regarding the relationships between healthcare professionals and industry. I'm still reading and digesting, so I'm not going to provide any comments right now, but stay tuned...

Reductions in the Pharma Sales Force

According to a recent ZS Associates survey, the number of US sales reps has decreased 10% since 2007. We now have 92,000 pharma sales representatives and the prediction is that it will continue to drop to 75,000 by 2012. With all the recent news about mergers, I wonder how that will impact these numbers. Many doctors are unwilling to see sales reps, so pharma/biotech/medical device companies are looking for alternative ways to send their marketing messages. e-marketing has been one of these options that many companies have embraced.