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Pharma and physicians: It takes two to tango
Thursday, October 23, 2008 - 03:03 PM - 2 months, 2 weeks ago - Blog - Health Business Blog Pharmaceutical companies are being scrutinized, and rightly so, for influencing physician behavior with sometimes immodest sums of cash and treats. Companies are starting to disclose and in some cases cap such payments. The latest example is GlaxoSmithKline, whose new CEO has announced plans to limit payouts to $150,000 per year per physician. (Of course most docs receive a lot less than that.) From the Financial Times (GSK to publish level of doctors’ advisory fees ) Andrew Witty, chief executive of the UK-based pharmaceutical company, said he was introducing tougher new rules to impose a cap “without exception” on such payments and promised to publish the amounts. His commitment comes at a time of growing concern that the widespread practice of payments by pharmaceutical companies may help unfairly influence “key opinion leaders” in the medical community, in a way that biases their judgments and recommendations for particular treatments… The pharmaceutical industry has taken steps in recent years to limit accusations of influencing doctors, curbing lavish entertainment and luxury travel under the pretext of supporting their attendance at academic conferences. But critics continue to question payments to individual doctors as speakers and advisers to companies, as well as the drug industry’s heavy sponsorship of continuing professional medical education. This article and others imply that pharmaceutical companies are solely to blame for the state of affairs and are being forced to open up under pressure. I don’t think that’s telling the whole story. In fact I doubt that Mr. Witty is upset about this turn of events. Physicians are highly trusted professionals with great influence over patients’ lives. The decision to prescribe a drug is in their hands. Despite the rise of direct to consumer advertising it’s still the physician with the ultimate power to make the prescribing choice. That power brings a lot of responsibility, and it’s critical that physicians maintain the trust of their patients and the public. When they seek or accept high payments from pharmaceutical companies for access, consulting, or as an inducement for prescribing that’s not a great thing. Some who collect these fees are a bit ashamed by their own behavior, which is why voluntary disclosure doesn’t work well. I know plenty of physicians who’ve decided not to accept payments from pharmaceutical companies. Every payment by a pharma company has a recipient on the other end. Let’s keep that in mind before bashing with such zeal. 2312 |
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Ruc-Ruc-Ruc
Thursday, October 23, 2008 - 01:54 PM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines The Stooges at the AMA have stuck primary care in the eye--again Medscape Family Medicine |
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Court Lifts Injunction That Keeps Endeavor From Rapid Exchange: Medtronic Mum on Plans
Thursday, October 23, 2008 - 01:40 PM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines Currently, Endeavor is the only DES in the US that cannot be used with the newer delivery system. Heartwire |
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Drug Maker Agrees to Suspend Rimonabant Marketing in Europe
Thursday, October 23, 2008 - 01:12 PM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines European regulators say rimonabant's benefits no longer outweigh its risks. Its manufacturer, however, says it remains committed to the drug and hopes to provide evidence to support its reevaluation in the future. Medscape Medical News |
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Welfare queens for modern times: ER freeloaders
Wednesday, October 22, 2008 - 08:07 PM - 2 months, 2 weeks ago - Blog - Health Business Blog Ronald Reagan used to pick on “Welfare Queens ,” black, urban, female welfare recipients who were supposedly living high on the hog by having lots of children and squeezing extra money out of the system. The image played to people’s stereotypes and was generally believed, even though it was always hard to find real-life examples. Meanwhile there were plenty of fat cats using tax shelters to avoid paying taxes, but they weren’t stigmatized. The uninsured seem to have become the new welfare queens. From the Boston Globe (Uninsured not to blame for ER waits ) Contrary to conventional wisdom, hospital emergency departments in the United States are not overrun by uninsured people who want free treatment, US researchers said today… “The uninsured are actually underrepresented in the emergency department. Seventeen percent of Americans are uninsured, almost one in five people. But in the emergency department, we see somewhere between 10 and 15 percent uninsured, closer to 10 percent,” [study author Dr, Manya] Newton said. One reason for this, she said, is that unlike the insured, people with no insurance are billed for the full cost of the visit. Readers of the Health Business Blog won’t be surprised by these findings, since I’ve written multiple times that the uninsured use the ER less than insured people . The perception that the uninsured are clogging up emergency rooms is a dangerous one, not only because of the bias it represents against the less fortunate, but also because it drives incorrect policy assumptions. One of the arguments for universal health insurance in Massachusetts and California was that it would [at least partly] pay for itself by shifting patients from the ER to primary care. Here’s what Blue Cross Blue Shield of MA said in its explanation of the Massachusetts health reform law back in 2006 : Since Massachusetts already pays at least $1.1 billion to provide health care for the uninsured, the additional funding requirements are expected to be modest. The bill will redirect the existing funds that currently pay for the cost of care, which is often accessed in the emergency room by people who lack insurance. In the future these funds will subsidize the cost of insurance, which will enable people to access care in more appropriate settings and establish relationships with PCPs. Actually what happens is the insured use all modes of treatment more. Providing people with health insurance means they’ll consume more of everything, as we’re seeing in Massachusetts. It’s not that shocking that cost influences people’s decisions on whether or not to seek health care services. I’m not surprised that hard economic times are causing people to delay or skip care they would otherwise have sought. Even insured people have substantial out of pocket costs, and those costs can be enough to make a difference, especially when the world around them seems to be going to pot. |
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U.S. FDA Expands Approval for J&J HIV Drug
Wednesday, October 22, 2008 - 07:15 PM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines U.S. health regulators have expanded approval for Johnson & Johnson's Prezista in combination with other drugs to treat HIV patients who are just beginning to take medication for the virus, the company said on Wednesday. Reuters Health Information |
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U.S. FDA Inspection System Outdated, Slow: GAO Report
Wednesday, October 22, 2008 - 07:13 PM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines The U.S. Food and Drug Administration's system that monitors inspections of drug manufacturing plants worldwide is outdated and inaccurate, according to a government report released on Wednesday. Reuters Health Information |
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New Trial Results Support Broader Role for Carotid Stenting, But CMS Again Refuses to Expand Medicare Coverage
Wednesday, October 22, 2008 - 10:27 AM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines Critics say the CMS should have waited for pending publications of the SAPPHIRE, CAPTURE 2, and EXACT data before announcing its decision, especially as new results from PROTECT, EMPIRE, and EPIC indicate that stroke, death, and MI rates are continuing to decline. Heartwire |
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Many Children Lack Health Insurance
Wednesday, October 22, 2008 - 08:16 AM - 2 months, 2 weeks ago - Newspaper & TV news - Medscape Business of Medicine Headlines In some cash-strapped homes, the parents are insured, but the child is not. WebMD Health News |
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Oh where, oh where is my Tablet PC?
Tuesday, October 21, 2008 - 07:03 PM - 2 months, 2 weeks ago - Blog - Health Business Blog Check out SimulConsult CEO Michael Segal’s article on medical use of tablet PCs at MD Net Guide. Mickey is a diehard proponent of tablet PCs in medicine. He even had a sport coat custom manufactured to fit his Motion LS800, which is about the closest to the right form factor he’s seen. The article lays out what’s needed in a mid-sized device for medical use, basically a hybrid of the iPhone and existing tablets: Phone –for communications on the go Big screen and small pen –fingers are great, but for handwriting recognition you really need a pen. The screen should fit in a white coat pocket Thin –like the iPhone, so it’s easy to carry Powerful –so it can be docked and used with a full-sized keyboard and screen Inexpensive –which means no hefty monthly contracts to drive up the cost of ownership I used to have a Tablet PC, too, a Motion Computing M1400. My motivation was a little different than Mickey’s. After a horrible customer service experience with an HP laptop, I decided to buy a computer from a company where I knew the CEO. (Motion founder and CEO Scott Eckert and I worked together in consulting 20 years ago.) The Tablet was pretty nifty and was especially good for use on an airplane while seated in coach. For office use I propped the Tablet up in its stand and connected it to a big monitor plus a Bluetooth keyboard and mouse. The Tablet was a great conversation starter and fit my self-image. It was especially useful for taking notes in meetings and I liked being able to look down at the screen and then up at the person I was speaking with –very much like a clipboard. Mickey thinks it will take “another generation of innovative chips, power-saving features, and bets on the right form factor before we see significant mobile computing in medicine.” He also doesn’t think such innovation will come from Apple, because “Steve Jobs would not be caught dead wearing a jacket or carrying a purse.” Google’s Android seems a more likely bet. 23d0 |
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