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Articles Posted in Conflicts of Interest

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Some noteworthy news items to start your week:

    • Tylenol: Tylenol drug recall expanded to include other Johnson & Johnson/McNeil products (Motrin, Benadryl, Rolaids, Simply Sleep, St. Joseph). See the manufacturer’s press release.
    • Radiation: Philadelphia Veterans Administration acknowledges that incorrect dosages of radiation were given to 114 veterans for prostate cancer. See the Legal Blog of Shrager, Spivey & Sachs.
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Here are some of the stories we’re following this week:

  • Janumet: Shearlings Got Plowed reports that the FDA is revising the label for Janumet to warn about pancreatitis. A link to the FDA’s prescribing information is here
  • Seroquel: Tom Lamb reports on the difficulties that plaintiffs are facing in these cases, of late. It seems that the odds are against us and the situation is grim—a good time for a reversal
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It will be a great year. If one of your new year’s resolutions is to follow industry news more closely, here’s some required reading:

  • Hormone Therapy: Bloomberg reports on the latest Plaintiff’s Prempro victory (actually, the drug at issue here was Provera, later combined with Premarin by Wyeth to make Prempro)—a Pennsylvania appeals court ruled that the trial court wrongly granted judgment for defendants, notwithstanding a jury verdict for Plaintiff. We’ll report more on this later in the week.
  • Conflicts of Interest: The New York Times notes that two Harvard Hospitals (Massachusetts General and Brigham and Women’s) have issued new guidelines on outside pay for senior officials. They can now only accept a maximum of $5,000 per day of actual work—and no stock. Importantly, the speaker’s fees from drug companies are prohibited for all employees. The momentum is good—let’s hope these attitudes spread.
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Here’s a list of some important stories we’ve been tracking.

  • Boston Globe article probing the financial ties between Massachusetts doctors and Eli Lilly, a large drug manufacturer. “When the [drug] company provides the PowerPoint [for the doctor’s presentation], the risk of bias is even greater.”
  • Seattle Post Intelligencer article examining the fatal overdose of a 15-year-old teen with autism. Michael Blankenship had a dental procedure and was given a Fentanyl Pain Patch. These are typically product liability cases, but it looks like Michael never should have received the patch in the first place, so Michael’s family has filed a medical negligence complaint.
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At the Medtronic annual shareholder meeting last week, CEO Bill Hawkins defended the company’s history of physician collaboration, though he noted that the relationships may create conflicts of interest.

However, the probes by the Justice Department and the Congress into the relationships prompted one shareholder to state that he was shocked by how much Medtronic paid physician “consultants.” For example, Medtronic paid Dr. David Polly the tidy sum of $1.2 million between 2003 and 2007. Hawkins says that his company monitors payments to physicians to avoid conflicts of interest.

Call us skeptical and jaded, but this is a story we’ve seen time and time again. It is interesting that Medtronic is professing themselves to be mostly free of blame—we look forward to the outcome of the investigations to see just how well Medtronic monitored the conflicts.

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A nice article from the Washington Post, Probing Doctors’ Ties to Industry, evaluates the recent movement for transparency in the relationships between the pharmaceutical and medical device companies and doctors. We’ve all been to the doctor and have seen pens and pads of paper touting the latest miracle drug, but that is only the tip of the iceberg. The pharmaceutical and medical device industry pays for doctors to attend symposiums (sometimes these are actually just really fancy vacations with a very small lecture component), dinners, and provides them with gifts of all kinds (from pens to much more valuable objects). It is estimated that Big Pharma spends over $20 billion per year pitching their wares to doctors.

What’s the impact? Like the rest of us, marketing influences doctors (if they weren’t, these industries would not be spending the money). So, a doctor is more likely to prescribe Drug A over Drug B if he just got a nice lunch from Drug A’s sales representative. You’d like to think that all doctors will sit in their library and compare the attributes of the drugs, poring over the Physician’s Desk Reference. But time is at a premium, and it’s often easier to listen to the sales reps (who are very rarely medically trained). The question is whether patients receive the proper drug or the properly marketed drug.

Of course, some donations are for the advancement of science. Doctors frequently receive free samples of drugs or devices for research studies they are performing—this helps pharmaceutical companies and medical device companies to determine the safety and efficacy of their products. Those should be reported as well, but they are less likely to influence a doctor’s prescribing habits.