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Media Coverage
''Is Psychiatry Committing 'Professional Suicide'?''
"British psychiatrist and Big Pharma gadfly David Healy is so controversial amongst his colleagues that some have tried to have his medical license revoked — but there he was, speaking at the American Psychiatric Association's (APA) second largest annual meeting at a well-attended session on conflicts of interest.
"It's a miracle that I was asked along to give a talk (here), and I'm extremely grateful," Healy said.
His disquisition was perhaps less humble.
Arguing that his profession is "committing professional suicide" by failing to address its dangerously close relationship with the pharmaceutical industry, he likened psychiatry's attitude toward its faltering legitimacy to the Vatican's widely derided response to its child-sex-abuse scandal by priests — essentially that psychiatry is brushing off justifiable concerns as hype instead of dealing with the source of the problem.
Few experts believe that psychiatry's relationship with the drug industry is healthy. While several speakers at the session pointed out that other specialties are similarly entangled with industry, "everyone does it" is generally not a valid defense where conflicts of interest are concerned."
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"As for what could be done to disentangle medicine from industry, Healy wasn't entirely pessimistic.
"The key issue in the short term is access to data. We have to insist on that," he said. "We let industry come to our meetings and let them talk in our programs. I don't think it's huge problem that they get paid. The big problem is that if you ask for data, they can't give it to you. That's not science, that's marketing masquerading as science."
But what of the issue of doctors being visited by paid-industry types — or being paid by industry themselves? The panel's organizer, Dr. Daniel Carlat, director of the Pew Prescription Project, noted a new disclosure law, passed as part of President Obama's health-reform bill in 2010.
Under the legislation, drug companies must reveal which doctors have taken any payment or gift from them worth more than $10, and describe the exact amounts taken and the purpose for them on a publicly available website. (Unfortunately that website will not be up and running until 2014 at the earliest.) All of the panelists agreed, however, that while public disclosure is good, it is not enough."
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"The legislation requiring public disclosure of the financial relationships between healthcare vendors and physicians has been widely discussed in policy circles for years. Critics claimed payments for speaking, consulting, research or even the small trinkets and meals delivered during routine sales calls unduly influenced physician choices and inflated healthcare costs. To combat those effects, Congress required public reporting of those payments in a publicly accessible database. The legislation, labeled the Physician Payment Sunshine Act, was included in the 2010 healthcare reform law."
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Prescription project director Danny Carlat identifies issues with the Physician Payments Sunshine Act requiring further clarification and guidance. Addressing those would ensure that manufacturers can appropriately implement the final rule, and enable consumers to benefit from transparency reports published by the Centers for Medicare & Medicaid Services.
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The Pew Charitable Trusts is working to decrease the influence of pharmaceutical marketing on doctors’ practices. With a three-year grant from the Attorney General Consumer and Prescriber Education Grant Program, Pew is collaborating several partners to improve conflict-of-interest policies within the 158 medical schools and 400 major teaching hospitals in the United States.
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The Pew Charitable Trusts appreciates this opportunity to submit comments to CMS's "Information Collection Activities" draft guidance. We suggest that both the research and non-research payment templates be modified in order to make it easier for consumers to identify which drugs, devices, biologicals, or medical supplies are associated with particular transfers of value.
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On Feb. 1, 2013, the Centers for Medicare & Medicaid Services published the final rule guiding implementation of the Physician Payments Sunshine Act, which Congress passed as part of the Affordable Care Act in March 2010 to increase transparency in the relationships between physicians and drug and medical device makers. Here are some of the highlights.
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"The Obama administration issued a new rule this month that requires the makers of prescription drugs and other medical products to disclose what they pay doctors for various purposes, like consulting or speaking on behalf of the manufacturer. This overdue rule adds much-needed weight to previous, more limited disclosure requirements."
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Allan Coukell, director of medical programs for The Pew Charitable Trusts, issued the following statement in response to the Centers for Medicare & Medicaid Services' final rule for implementing the Physician Payments Sunshine Act, which will bring transparency to the financial relationships between physicians and drug and medical device companies.
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In 2011, the pharmaceutical industry spent nearly $29 billion on drug promotion — more than $25 billion on marketing directly to physicians and almost $4 billion on advertising directly to consumers (mainly through television commercials). This multi-pronged approach is designed to promote its products by influencing doctors’ prescribing practices.
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"Harmonizing conflict-of-interest standards will depend on the Centers for Medicare & Medicaid Services moving forward to implement the federal Sunshine law, which is now more than a year behind schedule. Industry, consumers and academic stakeholders are all waiting on CMS to issue a final rule."
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Dr. Daniel Carlat, Director of the Pew Prescription Project, appeared before the U.S. Senate Special Committee on Aging to testify about the importance of implementing the Physician Payments Sunshine Act as quickly as possible.
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Pew Prescription Project Director Daniel Carlat opines in the Philadelphia Inquirer: "Monetary relationships among doctors and drug and device companies are not inherently bad; in fact, they are crucial for advancing medical research and patient care. Yet they can also skew prescribing practices and research results. That's why transparency and education are such an elegant solution: They allow these often important relationships to exist, but only on the condition that other professionals and patients are fully informed about them."
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"Every five years, lawmakers, lobbyists, patient groups and agency regulators line up to take their shot at changing how things get done at the Food and Drug Administration."
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The Pew Charitable Trusts “Pew” and Medtronic, Inc. are pleased to jointly comment on the Department of Health and Human Services, Centers for Medicare & Medicaid Services proposed rule implementing Section 6002 of the Affordable Care Act.
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Pew’s main goals in commenting on the proposed rule are to ensure timely implementation and to promote the interest of full transparency by ensuring that data is collected, reported, and published in the most complete, consistent and accurate manner possible.
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Allan Coukell, Deputy Director, Medical Programs
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