The drumbeat for Rx and medical device reform gets stronger

Case 1: Mass. Regulates disclosure of industry
As we discussed here, the Boston Globe recently reported on a medical convention that was pulling out of Boston for a 2015 convention. The American Academy of Allergy, Asthma & Immunology pulled out because they say it is difficult to find “sponsorships and to provide education courses under current legal condition.” “Current legal condition” refers, of course, to the recently passed Chapter 305 of the Acts of 2008 and the DPH regulations of industry interactions with providers. We continue to be perplexed by this action since the law only mirrors the current accreditation guidelines (download here) and the voluntary PhRMA code. We are not alone. Dr. Bruce Friedman says:

I feel compelled to weigh in on this topic as I have in a previous note because I have participated in, and managed, CME conferences for many years … A “fire wall” must be placed between the didactic content provided by the faculty and the sales efforts of the vendor representatives. In my experience, such a barrier is not that difficult to erect. The lecture area must be a “no spin” zone.

It strikes me as childish and precipitous for the American Academy of Allergy, Asthma and Immunology to pull a conference that will occur six years in the future for lack of [pharmaceutical] sponsorship. There is a political agenda at work here. I recommend that everyone concerned take some deep breaths. A new modus operandi needs to be developed between the pharmaceutical companies and the professional societies pertaining to the structure, organization, and funding of conferences along the lines described above. This probably won’t happen overnight. However, the fact remains that physicians need to attend conferences and the company representatives need an opportunity to interact with them. These interactions may not be as frequent in the physician office settings because of the high cost of such calls. My guess is that medical conferences will continue but with new rules, even in Massachusetts.

Case 2: PhRMA says no to comparative effectiveness
As we wrestle with reducing health care costs and start to spend our health care dollars differently, various entities, like PhRMA could lose money- big money. Comparative effectiveness research (for more information click here and our blog here) is one of the ways to increase value in our health care system. The plan is that a federal or state entity would conduct independent reviews of the comparative effectiveness of therapies and procedures so that health plans, hospitals, and public health programs can “spend smarter” on health care. This would include comparing drugs to one another and ranking their efficacy. Today, Ezra Klein writes:

Doc-blogger Kevin Pho — no liberal, and no fan of government action — writes in defense of federally-funded comparative effectiveness research. “Physicians need an authoritative source of unbiased data, untainted by the influence of drug companies and device manufacturers,” he writes. “With treatments and medications announced daily, having an entity definitively compare these newer, and often more expensive, options with established treatment regimens will be particularly useful in everyday practice.”

The fight over comparative effectiveness research is really a fight over who controls information. Right now, the pharmaceutical industry pays for most of the research and funds the most effective research distribution service (this service, incidentally, comes in the form of leggy former-cheerleaders and Miss America contestants…). That’s good for the pharmaceutical industry, which can emphasize the research aligns best with their business strategy.

The threat of comparative effectiveness review is that Pharma loses control of the information. An alternative information pipeline opens up. This one, to use Kevin’s evocative sentence, would be “untainted by the influence of drug companies and device manufacturers.” (It also won’t be delivered by former cheerleaders.) The sudden controversy over the comparative effectiveness money in the stimulus was a well-orchestrated backlash funded by the pharmaceutical industry. As one plugged in consultant told me today, “I’ve never seen anything like the pharmaceutical industry’s mobilization over the language in the House bill.”

But don’t begrudge Pharma its efforts. As Kevin says, “their motives in attempting to quash comparative effectiveness research could not be more obvious.” The current regime is good for profits. And protecting profits is Pharma’s job. But it’s not good for the public. And protecting the public welfare is the government’s job.

We vote with Ezra Klein and Dr. Friedman: protect people, not profits.
Georgia Maheras