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.
