The medical board of the National Academy of Sciences issued a set of recommendations that amount to the most stringent proposal yet on regulating industry gifts and payments to doctors.
Physicians should not accept any meals, trips or other gifts from companies, abstain from clinical trials if they have a stake in the outcome and not sign ghost-written articles. Nor should physicians participate in clinical trials if they have a financial interest in the outcome, or sign on to ghost-written articles, according to the institute’s recommendations.
And professional medical societies shouldn’t accept industry funds to help develop treatment guidelines, the IOM recommended, adding that there should be a central, public repository detailing all industry payments to doctors:
“Congress should require pharmaceutical, biotechnology, and device firms to report through a public Web site the payments they make to doctors, researchers, academic health centers, professional societies, patient advocacy groups, and others involved in medicine. A public record like this could serve as a deterrent to inappropriate relationships and undue industry influence. It also would provide medical institutions with a way to verify the accuracy of information that physicians, researchers, and senior officials have disclosed to them.
“The report calls on researchers, medical school faculty, and private-practice doctors to forgo gifts of any amount from medical companies and to decline to publish or present material ghostwritten or otherwise controlled by industry. Consulting arrangements should be limited to legitimate expert services spelled out in formal contracts and paid for at a fair market rate. Physicians should limit their interactions with company sales representatives and use free drug samples only for patients who cannot afford medications. Several professional organizations and industry groups have set new limits on gift giving and other relationships between industry and the medical community, but it is too soon to gauge the effects these changes.”
Thomas Stossel, a professor at Harvard Medical School, told the Wall Street Journal (subscription) that the proposal to reduce industry funding of medical education would deprive physicians of the latest information about treatments.
“There is no evidence for the need of these regulations,” Stossel told the journal, adding that he has been involved in start-ups and worked with industry. “It’s high-end welfare for the ethicists and maybe job security for the academic administrators.”
The recommendations are the latest in a series of regulations seeking to eliminate conflicts of interest between doctors and industry. In addition to the Massachusetts law limiting payments to physicians, Johns Hopkins University enacted strict limits on industry contact with its docs and Partners Healthcare barred industry sales reps from its halls.