[Ip-health] Politico (EU) : Health companies clash on cozy doc ties

Thiru Balasubramaniam thiru at keionline.org
Wed May 27 07:08:14 PDT 2015


http://www.politico.eu/article/health-companies-clash-on-cozy-doc-ties/

<SNIP>

Consumer groups say no way.

Self-regulation does not work, said Tim Reed, executive director of Health
Action International. Doctors are inevitably influenced by perks in the
drugs and products they choose to use, he said.

“This is part of a strategy to preempt being forced into action by
legislation,” he told POLITICO.  “Influencing product choice leads to
sub-optimal — and expensive — treatment.”

--

Health companies clash on cozy doc ties

Most companies now think twice before taking doctors to Disneyland — but
the medical device trade group wants to go a bit farther.

By PETER O’DONNELL



27/5/15, 5:30 AM CET



Updated 27/5/15, 11:23 AM CET

Health care companies in Europe are split over how to burnish their image
amid growing disquiet over cozy and undisclosed ties between industry and
physicians.

Drug and device makers are scrambling to put in place new policies after a
series of high-profile scandals ranging from faulty breast implants to
fatal prescribing of diabetes drugs. But they are still struggling to
reconcile views on the way forward.

Acting on a decision by Europe’s main pharmaceutical trade association,
drug firms in Europe will next year detail their dealings with healthcare
professionals — specifying how much each doctor received from industry to
travel to and attend conferences and in speaking fees, among other payments.

This will bring them partly into line with US rules under the so-called
Sunshine Act, which obliges full disclosure of such ties.

Drug makers are gearing up for the new reporting — but they still plan to
fund doctors’ attendance at conferences, known as direct sponsorship of
healthcare professionals.

By contrast, European medical device companies are likely to impose a
strict ban on this practice. The board of Medtech Europe, their main
industry association, will hold a crucial vote in December on adopting the
rule.

“There is still work to do” to convince all the association’s members that
this is the way to go, Medtech Europe CEO Serge Bernasconi told POLITICO.

Much of the devices industry in France, for instance, is still opposed, and
is discussing pulling out of the trade group if a ban comes in, industry
sources say.

Doctors say they are independent and not swayed by free samples or a free
hotel room at a conference, but studies over the years have suggested
otherwise.

And beyond the issue of paying for trips for doctors, the debate now
extends into what role health care companies should have in medical
education, if any.

Evidence of health care companies’ efforts to influence doctors’ behavior
has piled up over the years, from questionable inducements to outright
bribery and corruption.

At its most trivial, a crackdown a decade ago on free golf outings for
doctors left one firm with an entire container-load of golf balls. Gifts
and lavish entertainment are now prohibited in the EU and the US, and free
product samples strictly controlled.

A combination of litigation, legislation and tighter voluntary codes has
eliminated some of the most flagrant abuses.

Most companies now think twice before taking groups of doctors to
Disneyland.

And most companies now think twice before taking groups of doctors to
Disneyland — although a Croatian orthopedic firm was recently in trouble
for promising trips to Las Vegas or Los Angeles as a reward for prescribing
its products.

But companies insist that they need to maintain links with doctors.

EFPIA‘s own code says that doctors are the primary point of contact with
patients.

In the devices industry, where physicians physically manipulate and insert
many products, personal experience is vital to feedback and to promoting
innovation, say companies in the sector.

Industry representatives in Europe largely contend that self-regulatory
codes now being put in place are enough to protect patients and payers.

Consumer groups say no way.

Self-regulation does not work, said Tim Reed, executive director of Health
Action International. Doctors are inevitably influenced by perks in the
drugs and products they choose to use, he said.

“This is part of a strategy to preempt being forced into action by
legislation,” he told POLITICO.  “Influencing product choice leads to
sub-optimal — and expensive — treatment.”

Compliance and enforcement are a challenge, even company advocates of
self-regulation admit.

“There is a very steep learning curve for everyone,” said Stefan Wolf, CEO
of Siemens Healthcare Diagnostics, said at a meeting on compliance in the
device industry, in Athens last week. “You need to get down to lower levels
of the company to ensure compliance.”

The point was echoed by Mike Mussalem, CEO of Edwards Lifesciences: “It’s a
question of getting it down the line from associations to member companies
and from CEOs to staff.”

Pressure from the US is changing the game. American firms are increasingly
aware that authorities there might invoke domestic legislation to prosecute
them for conduct overseas that is banned at home.

This has helped drive a global-level push to ban paying for doctors to
attend conferences, according to Carolyn Bruguera, a vice president at
compliance consultancy R-Squared.

She points to firms that have voluntarily stopped all payments for doctors
to attend conferences, including medical device manufacturer Covidien and
pharma majors AstraZeneca and GlaxosmithKline.

There is a grey area, however, between sponsoring conference visits and
sponsoring education.

“The Sunshine Act doesn’t shed much light on medical education, since
payments to physician societies and most other continuing education
providers are not covered by the law,” said Bruguera.

Many companies are strongly in favor of maintaining support for medical
education. Stefan Wolf, CEO of Siemens Healthcare Diagnostics, said in
Athens last week his company does not pay for doctors to attend medical
congresses.

But he warned that “if we stop funding education we stop progress, because
there is not enough government funding of medical education. If the
diagnostics sector stops supporting standardization there will be no
progress.”

Ima Parrondo, a lead officer for healthcare compliance at Johnson &
Johnson, told POLITICO the company still favors paying for healthcare
professionals to attend educational conferences “but always on quality,
never related to prescriptions, and only to make presentations, never just
for participation, and never in inappropriate locations.”

As a matter of principle it always abides by local rules, she said, so if
MedTech Europe votes to ban direct sponsoring, “we will follow whatever
decision emerges.”



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