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Healthy Skepticism Library item: 16443

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

Ryle G, Mckenzie N
Meals, trips used to sway choice of devices
The Sydney Morning Herald 2009 Sep 7
http://www.smh.com.au/national/meals-trips-used-to-sway-choice-of-devices-20090906-fctu.html


Full text:

SPECIAL INVESTIGATION

SOME medical device companies have made secret financial arrangements with doctors in an attempt to influence the brands they implant in their patients.

Millions of dollars are being spent on meals at upmarket restaurants, overseas trips to medical conferences and consultancy fees for research, according to industry insiders.

In one case, a Sydney doctor visiting Melbourne was flown by helicopter from Monash Medical Centre to the airport so he would not have to endure peak-hour traffic.

The revelations come amid fears that some implants have been subject to inadequate testing or monitoring by the Federal Government, exposing thousands of patients to risk.

One senior Health Department source said the oversight regime was a ‘‘shambles’‘, partly because it relied on companies dobbing themselves in when their implants – which include artificial knees, hip replacements and pacemakers – fail. In the past four years, 181 patients have been killed and another 2146 injured – 1027 of them seriously – in incidents related to medical devices, according to the Therapeutic Goods Administration.

The figures have jumped sharply over the past 12 months.

The Herald has learnt that senior TGA officials are concerned some companies are self-registering products as implants rather than medicines to avoid proper scrutiny.

Surgeons and TGA sources are also concerned that doctors are using implants in ways that go beyond their approved use, a problem potentially heightened by the aggressive marketing approaches some companies use to push their products.

The potential danger is magnified because of the sheer volume of procedures that take place in Australia, a figure that grows every year.

More than 65,000 artificial knee and hip replacements were done last year at an estimated cost of more than $1 billion, a figure that has doubled in the past decade and is projected to double again in the next.

Australia has one of the highest knee replacement rates in the world, according to the national joint replacement registry.

The Herald is not suggesting improper relationships were involved in all medical decisions to implant new knees or hips but the example highlights the growing role implants play in patient care.

According to insiders, many of the products doctors are encouraged to use have gross profit margins of up to 92 per cent. But the Herald is not suggesting the companies or the doctors are acting illegally. There appear to be no specific laws, only voluntary codes of conduct.

The medical device industry is now a $3 billion-a-year market, and the NSW Government is the biggest single customer, according to public submissions to the Federal Government by the industry body, the Medical Technology Association of Australia.

But Michael Grigg, the chairman of the Royal Australasian College of Surgeons’ professional standards committee, said he was “not specifically aware of any cases” of surgeons receiving payments. “Despite this the college acknowledges that there is a perception that the relationship between surgeons and industry could compromise the relationship between surgeons and the patient,” he said.

Professor Grigg said the college had recently introduced a new code of practice for stricter guidelines.

 

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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