[e-drug] Drug Companies to reveal grant practices in USA

["E-drug" <e-drug@healthnet.org>]

E-DRUG: Drug Companies to reveal grant practices in USA
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http://sfgate.com/cgi-bin/article.cgi?f=/n/a/2008/04/11/national/w010849D26.
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[copied as fair use. HH]

Drug Companies to Reveal Grant Practices
By KEVIN FREKING, Associated Press Writer

Friday, April 11, 2008


For years, the nation's largest drug and medical device manufacturers have
courted doctors with consulting fees, free trips to exotic locales and
sponsoring the educational conferences that physicians attend.

Those financial ties in most cases need not be disclosed and can lead to
arrangements that some say improperly influence medical care.

Now, under the threat of regulation from Congress, the two industries are
promising to be more forthcoming about their spending. A dozen of the
nation's leading drug and device makers have told Sen. Charles Grassley,
R-Iowa, that they have plans or are working on plans to publicly disclose
grants to outside groups. The details will be provided on each company's Web
sites.

Watchdog groups say the companies are trying to derail legislation that
would require public disclosure of their giving.

"If they were doing this out of the goodness of their heart, they would have
done so decades ago," said Dr. Peter Lurie of the consumer group Public
Citizen.

Of particular interest to Grassley, top Republican on the Senate Finance
Committee, is the money companies spend on continuing medical education.
Physicians attend such conferences to fulfill their license requirements and
to keep up to date with the latest treatment trends. Professional
associations and companies frequently ask drug and device makers to help pay
for the conferences. Recently, Grassley asked 15 companies whether they
planned to follow the lead of Eli Lilly & Co., which now discloses its
grants to such programs.

"If your company does not yet have any efforts or plans in place, please
explain why not," Grassley wrote.

The responses are in. They are wide-ranging but mostly what the senator
wanted to hear. Indeed, many of the companies said they would go beyond
disclosing grants for medical education. Some companies said they would also
disclose payments to patient advocacy groups such as the American Heart
Association or the American Diabetes Association. Boston Scientific said it
was developing a system that even discloses certain payments to physicians.

Medtronic Inc. said it will post payments for professional meetings and
patient groups on its Web site beginning May 1. AstraZeneca PLC said it
would do the same on Aug. 1, providing the amount spent and the purpose of
the financing. AstraZeneca gets 4,000 to 5,000 grant applications each year
and funds about a third of them.

Merck and Co. was vague about its plans, but committed to the concept. "We
are currently in the process of developing an action plan," the company
wrote to Grassley.

Amgen Corp. and Abbott Laboratories said they had formed working groups to
determine how to compile and display their grants.

Schering-Plough Corp., however, told the senator what he didn't want to
hear: "We do not publish or have plans at the moment to publish a list of
charitable contributions or educational grants that medical organizations
have received from us."

Grassley said, overall, he was happy with the responses.

"The way these companies are making information about financial
relationships open to scrutiny is the right thing to do," he said.

Two other companies said they already were disclosing third-party payments.

The two, Zimmer Inc. and Stryker Orthopedics Inc., avoided criminal
prosecution over financial inducements paid to surgeons to use their
products, prosecutors announced last year. The companies agreed to new
corporate compliance procedures and federal monitoring. Zimmer also had to
pay the government $169.5 million.

The hip-and-knee industry was the subject of a recent Senate Aging Committee
hearing titled "Surgeons for Sale." Companies routinely paid doctors $5,000
every three months for providing information on market trends and
operating-room activity. However, the reports typically offered only cursory
descriptions and often were duplicated from one quarter to the next. Also,
companies sponsored consultant meetings at resort locations. The meetings
lasted just a few hours each day. The physicians who presented information
at the meetings spoke for as little as 10 minutes.

"Although the remainder of the day was available for recreational activities
paid for by the company, the consultants were compensated $5,000 for a full
day of work," said Gregory E. Demske, an assistant inspector general.

Eli Lilly began listing its grants last year. It gave $18.9 million in the
second quarter of 2007, according to the Prescription Project, a
Boston-based group that promotes policies to reduce conflicts of interest.

"They support those organizations which they believe will have a positive
impact on their drug sales," said David Rothman of Columbia University and
associate director of the Prescription Project. "It's self-evident but
important."

If all of the companies follow through with their commitments to Grassley,
there also would be widespread disclosure of how much money they give
patient advocacy groups. The groups rely on industry for much of their
financing. For example, the American Heart Association said donations from
the pharmaceutical and device industry make up about 6 percent of its annual
income, and totaled $48.3 million in the organization's latest fiscal year.

"Donations from corporations, including the pharmaceutical and device
industry, allow us to further enhance our programs and outreach, and to
bring objective science and the highest quality of public education and
information to more people," said Maggie Francis, the association's
communications manager.

Grassley and Sen. Herb Kohl, D-Wis., have introduced legislation that would
require drug and device makers to disclose anything of value given to
physicians, such as payments, gifts or travel.

The disclosure of medical education grants is an extension of that concept.
Last year, the staff for the Senate Finance Committee issued a report that
said the drug industry may be using the "medical education industry to
deliver favorable messages about off-label uses that the drug companies
cannot legally deliver on their own."

The committee report noted that Warner-Lambert, now owned by Pfizer Inc.,
paid $430 million to settle claims that medical conferences it sponsored
were used to illegally promote off-label uses of the anti-seizure drug
Neurontin. Serono-Laboratories paid $704 million to settle a similar claim
concerning the AIDS drug Serostim.

In a few states, such as Vermont and Minnesota, drug companies must disclose
certain payments to physicians. Baxter International Inc. told Grassley that
it could support legislation setting a national disclosure standard, but
it's critical the standard pre-empt state laws.

"Overlapping and conflicting state requirements have created, and would
continue to create, duplication, uncertainty, and burden in complying with
them," a Baxter official wrote.

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On the Net:

Senate Finance Committee Report:
www.senate.gov/finance/press/Bpress/2007press/prb042507a.pdf

The Prescription Project: www.prescriptionproject.org