A physician with Kaiser Permanente told us recently how that nonprofit health-care provider deals with gifts from makers of drugs and medical devices: “None of our surgeons can receive anything of any significant benefit from any company, so nothing more than $25 a year per vendor. You can’t accept meals or trips or honorariums or consulting fees. If you go to dinner with a rep to learn about new products, you just have to pay for it.”
Score one for the patient. Physicians who are not influenced by industry reps are more likely to prescribe the best treatment rather than the drug on the mug they were given last week. The Institute of Medicine believes that gifts and payments create conflicts of interest that “may jeopardize the integrity of scientific investigations, the objectivity of medical education, the quality of patient care, and the public’s trust in medicine.”
Other hospital systems are joining Kaiser Permanente in restricting gifts, including the Department of Veterans Affairs and several dozen academic medical centers. But influence peddling by the makers of medical products—and the willingness of physicians to participate—is still far too prevalent.
Vermont is one of the few states that have set their own protections. Bans on most gifts and required public disclosure of allowable expenditures have led to a 50 percent drop in pharmaceutical marketing dollars in that state, from some $4 million in 2004 to around $2 million in 2010.
Thanks to recent health-care-reform laws, transparency is about to go national. Starting in 2013, drug and medical-device manufacturers must publicly report gifts and payments to physicians and teaching hospitals. Companies can hold off publishing (but not reporting to the government) legitimate payments if revealing them could hurt their business. It would be far better if such payments didn’t happen.
If you want to see whether your doctor or hospital has been paid by any of 12 drug companies, go to ProPublica's Dollars for Docs page.
This monthly letter to subscribers from Consumer Reports President Jim Guest highlights the critical consumer issues behind our current reports. See archived letters.
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