Letting patients know industry-doctor links
May 16,2008 00:00 by The Indianapolis Star

Eli Lilly and Co., along with a fellow Indiana firm, showed integrity, initiative and good business sense in endorsing federal legislation aimed at shedding light on relationships between physicians and companies that produce drugs and medical devices.

The modest bill would require companies to report any gifts to a doctor totaling $500 in value over a year's time, excluding product samples, loans for equipment and certain educational materials and training. It would punish non-compliance with annual fines as great as $250,000 or as small as $1,000.

Those terms ought to be acceptable to everyone in an industry faced with mounting public and official concern over its financial ties to doctors and medical students. Yet Lilly on Tuesday became the first drug manufacturer to endorse the bill to create a national registry of physician payments.

It is "watered-down" legislation, says Dr. Peter Lurie, director of Public Citizen's Health Research Group. The consumer lobby wanted samples included in reporting, for example, and deems the penalties negligible. But Lilly, in Lurie's view, "has the more enlightened view compared to the rest" of the industry. Meanwhile, Zimmer Holdings, a leading medical device maker in Warsaw, Ind., likewise expressed support for the measure. Warsaw is the home of three of the nation's top five orthopedic device manufacturers. Though there was no admission of wrongdoing, the five were fined $310 million in a 2007 settlement with the Justice Department over alleged payments to doctors.

Such incidents are not common; but as a Lilly spokesman acknowledged, the possibility of conflict of interest in the public mind is a national problem that must be addressed by transparency at the national level.

Most doctors receive freebies of some sort from drug companies, according to an authoritative survey, and a substantial minority gets paid outright to speak, consult or enroll patients in clinical trials.

Lilly has been out front on this general issue already. It is the first drug company to post clinical trial data on its Web site and the first to disclose its educational grants and charitable gifts.

Other companies, along with trade groups, professional associations and medical schools, have adopted codes in recent years regarding relationships and disclosure. Well they should, inasmuch as states, as well as Congress, have begun taking their own action.

In a broad sense, those who produce and those who prescribe in the health field are colleagues. The professionalism of their relationship, however, faces enormous pressure from the high stakes and aggressive marketing that characterize the business sector, especially pharmaceuticals. Openness can relieve that pressure and spare patients and providers alike a great deal of pain.

Reprinted from The Indianapolis Star – CNS.