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Healthy Skepticism Library item: 13817

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Dombrowski C.
AMA Delegates To Debate Gift Reporting; Sunshine Bill Still Has Ray Of Hope
FDA Legislative Watch.com 2008 Jun 17
http://www.fdalegislativewatch.com/2008/06/ama-delegates-t.html


Full text:

The American Medical Association will evaluate mandatory disclosure of financial relationships between physicians and the pharmaceutical industry during the group’s June 14-18 House of Delegates meeting in Chicago.

The House of Delegates establishes AMA policy positions that guide lobbying on legislative and regulatory matters.

The California delegation is proposing a resolution that calls for annual reporting by drug and medical device companies of all payments to physicians with a value of more than $100. Product samples for patients and meals provided in conjunction with educational meetings would be exempted. The resolution is silent on whether the reporting should be to a state or federal government agency.

The resolution cites incentives for off-label prescribing, lessened public confidence in physicians, and existence of state reporting laws as part of the rationale for the proposed policy.

In addition, the delegates have before them a resolution from the Missouri delegation calling on AMA to work with the Accreditation Council for Continuing Medical Education to develop more specific criteria for disclosing relationships between continuing education providers and commercial interests. AMA’s Council on Medical Education has recommended an alternative resolution that directs AMA to monitor implementation of ACCME’s standards for commercial support of CME.

AMA’s debate is timely, as supporters of mandatory reporting on the national level continue to press for its enactment by Congress. Last year, AMA declined to take a position on the issue in Senate hearings because members had not discussed it.

The Pharmaceutical Research and Manufacturers of America and some individual drug companies signed on to a revised version of the Physicians Payment Sunshine Act, S. 2029, developed by Sens. Herb Kohl., D-Wis., and Chuck Grassley, R-Iowa (1“The Pink Sheet,” May 26, 2008, p. 17). It would set up a national reporting registry of physician gifts and payments.

Grassley had said he would try to add the measure to a “must-pass” Medicare physician package, but it appeared in neither his nor the Democratic versions of that bill (2“The Pink Sheet,” May 19, 2008, p. 3). There was some speculation it would be brought up as an amendment during Senate floor debate. In any case, senators are back to the drawing board on the Medicare package, as they declined to allow it to move to a floor vote (see 3preceding story).

Lilly, which endorsed the revised sunshine measure in May, says it still is “hopeful that bi-partisan action will lead to inclusion of the Sunshine Act in the Medicare legislation.”

Consumers Union would like to see a strong bill passed this year, the group’s Steven Findlay said in an interview, noting that a coalition of consumer groups is seeking further changes to the revised S. 2029. Those changes include a clarification that the federal law would pre-empt only state reporting laws, not those that also ban company gifts to doctors, and a requirement for companies to report the total amount they pay to physicians.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909