Friday, April 17, 2009

Partners COI Policy: Better than Hopkins, But Not Great

Partners has anounced that it will implement a new conflict of interest policy. You can read the press release and summary of the policy here. I also recommend reading the excellent Boston Globe coverage here.

The good:

--A sweeping ban of all gifts, including meals and textbooks. This makes it a true gift ban, unlike John's Hopkins half hearted gift ban which I panned here.
--While industry funds for CME will still be accepted, they will have to be pooled into a hospital-wide President's Fund, or they will have to be approved by a newly established "Educational Review Board." Any program that passes muster with this new ERB must be jointly funded by at least two companies, lessening the potential for product-specific promotional bias.
--Faculty will no longer be allowed to be hired guns for drug companies.

The bad:

Let's get real. Industry funds education in order to promote their products. Thus, any CME program that holds itself out as "independent" of industry influence, is inherently a deception. It's rather embarrassing that the Harvard hospitals, with their incredible endowments, brainpower, and prestige, can't simply get it together to do the right thing, which is to say: WE WON'T TAKE ANY DRUG COMPANY MONEY FOR PHYSICIAN EDUCATION.

4 comments:

Supremacy Claus said...

Dan: Where is the evidence of Harvard brain power in psychiatry? To which faculty would you refer anyone you cared about?

Nancy Frugé said...

Daniel Podolsky, M.D., chaired the Partners Commission on Interactions with Industry before leaving Partners to serve as president of UT Southwestern Medical Center—Dallas, according to the press release. Dr. Podolsky’s yearly salary is reportedly $1.2 million (Salaries of top UT execs rose sharply along with steep tuition hikes, report says. The Dallas Morning News. February 14, 2009.)

Although Dr. Podolsky will not benefit directly from the fruits of his labor on the Commission, he can certainly take pride in his contributions to the recommendations.

The Commission recommended that drug samples be distributed through a central pharmacy rather than through individual physicians. This may deter drug companies from the practice of making "seeds" out of physician/researchers:
http://carlatpsychiatry.blogspot.com/2008/08/new-documents-merck-used-doctors-and.html

However individuals who have come to rely on benefits derived from industry relationships, such as additional income and impressive vitae, will find ways to get around the rules.

According to an article in The Dallas Morning News, “The Texas Attorney General’s office will soon take to trial a drug company it believes used these perks to get its pharmaceuticals onto a state mental health protocol. Some UT researchers working on the protocol were the alleged beneficiaries.

‘There is appropriate concern that if individuals have [pharmaceutical] interests...it has the potential to undermine the integrity of the research,’ said UT-Southwestern Medical Center president Dr. Daniel Podolsky, who also serves on the drug company GlaxoSmithKline’s board of directors. ‘We need to be sure physicians in our centers aren’t letting that intrude on their judgment of what pharmaceuticals should be on our formularies.” (University of Texas officials vow to strengthen ethics rules for researchers. The Dallas Morning News. February 12, 2009.)

Nancy Frugé said...

A Texas bill that would require drug companies to report perks given to health care providers has stalled in a Senate committee. No one is quite sure why the bill was pulled from the committee meeting schedule on Tuesday. (Pharmaceutical reporting bill tied up in Senate committee. The Dallas Morning News. Thursday, April 23, 2009.)

Meanwhile, the new president of UT Southwestern in Dallas announced that the dean of the medical school is stepping down to direct a state-funded institute for cancer research. Read the story here;
http://www.utsouthwestern.edu/utsw/cda/dept493066/files/526527.html

and here:
http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/042409dnenttexascancer.c89fce.html

The dean will remain on campus in Dallas because, according to the report, “...he wanted to stay in an academic environment full of researchers.” What message does this send to the research community in Austin and to future employees of the new research institute?

Funds for the venture have yet to be approved by the Texas legislature.

Nancy Frugé said...

Update: A Texas bill that would require public disclosure of financial relationships between physicians and drug companies won committee approval this week. Source: Emily Ramshaw, Drug disclosure bill heads to full Senate, The Dallas Morning News, Trail Blazers Politics Blog, May 11, 2009.

References for my previous post:
Dr. Alfred Gilman’s new position, Messages from the President, UT Southwestern Medical Center, April 23, 2009. Available at http://www8.utsouthwestern.edu/

Sue Goetinck Ambrose, UT Southwestern dean to oversee Texas' cancer grants, The Dallas Morning News, April 23, 2009. Available at http://www.dallasnews.com/