Public Citizen

Between the financial meltdown, the on, off and on again presidential debates and the drama over the bailout negotiations, there were a few news items that got buried in the back pages (as if people still turned actual pages to get their news). The Wall Street Journal had a story about some allegations that, if true, offer an insight to how medical-device maker Medtronic gave doctors all sorts of inducements, including strip club visits, to gain their business.

According to the WSJ, a lawyer’s whistleblower suit against Medtronic, her former employer, included these allegations:

Kelley’s suit says kickbacks were “pervasive” at Medtronic. Sales staff, she said, “routinely took physicians” visiting the spine unit’s Memphis headquarters to the Platinum Plus strip club, and picked up the tab for the dancers’ services during “VIP visits.” Kelley, reports the WSJ, also claims that on a five-day, all-expenses-paid trip to Alaska in 2001, which was billed as a “think tank,” doctors were supposed to present case studies. But, according to the complaint, little discussion of the case studies took place. One doctor scheduled to give a talk stood before the group, “said he was sorry, but he had not prepared anything,” and “drinking then commenced in place of discussion.”

Ed Silverman blogs about the allegations at Pharmalot:

Kelley’s suit said Medtronic had consulting agreements with more than 100 surgeons that were “nothing more than a vehicle to pay the surgeons” to use Medtronic devices, instead of rival products. How so? Kelley alleged Medtronic paid patent royalties to docs who didn’t contribute novel ideas to products, created Web sites for them to market their practices, hired business consultants that helped doctors boost profits. She also clamied Medtronic offered twice-a-year seminars in Orlando and Las Vegas where docs and hospital administrators received free management advice, and supplied physicians with office staff.

Stay tuned to this one. Sens. Charles Grassley and Herb Kohl are deep into an investigation into kickbacks to doctors from the medical device and pharmaceutical industries. Public Citizen has long decried the flow of cash and gifts to doctors.

The heat from Grassley and Kohl is probably what was behind announcements this week by pharma heavyweights Ely Lilly and Merck that they will begin reporting the payments they make to doctors. Benedict Carey’s story, “Drug maker to reoport fees to doctors,” in the New York Times says that in the last year and a half the Grassley probe has “found that prominent researchers at several institutions, including Harvard and the University of Cincinnati, failed to report millions of dollars in outside income from drug makers, contrary to the institutions’ reporting requirements.”

As the NYT story points out, research shows that industry money can influence how doctors interpret data and can affect their prescribing habits.

Dr. Peter Lurie, deputy director of Public Citizen’s Health Research Group, is skeptical about the move toward self-disclosure. In Kevin Freking’s AP story, Lurie said other pharma companies are unlikely to follow suit, there will be no enforcement of the guidelines and that Lilly’s decision to report payments of $500 or more leaves a lot of wiggle room for meals and other perks.

“There are dozens of pharmaceutical companies. This is just one of them. Most won’t follow this guideline at all, and there will be no enforcement,” Lurie said. “This is Ely Lilly’s attempt to forestall the federal legislation by saying we’re in effect complying anyway.”

Public Citizen, a consumer advocacy group, also objects to the $500 threshold for reporting. Lurie said it should be much lower – $25 per gift.

“Most of what will wind up being disclosed is speaker’s fees, consulting and research grants,” Lurie said. “But most people want to know more than that. They want to know about meals, travel and that sort of thing. A lot of people will be cut out by the $500 annual limit.”