Healthy Skepticism Library item: 15088

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Publication type: news

Burton TM.
Spine Doctors are Adopting Strict Rules on Payments
The Wall Street Journal 2009 Jan 24
http://online.wsj.com/article/SB123275818015611957.html

Full text:

A medical society representing U.S. spine surgeons has taken the rare step of requiring that researchers disclose not just the existence of financial ties to medical-device companies, but the dollar amounts as well.

The initiative is a response by the North American Spine Society to pressure from lawmakers, prosecutors and lawsuits by companies’ former employees. Prominent surgeons doing research have been found to have significant financial relationships — sometimes to the tune of millions of dollars — with medical-device firms.

NASS, which has more than 5,000 members, said the new disclosure policy will apply to doctors who present studies at future medical conferences.

The society said its policy “is not a voluntary guideline, but a binding covenant which applies to all relationships engaged in by all participants in all” activities of the spine society. Failure to disclose would be a “sanctionable offense,” the spine society said. Sanctions could include suspension, expulsion or public letters of censure. NASS sanctions wouldn’t have any effect on a doctor’s ability to practice, only on membership in NASS.

“It just became clear that more transparency is better,” said the spine society’s ethics-committee chairwoman, Marjorie Eskay-Auerbach, an orthopedic surgeon in Tucson, Ariz. She said she doesn’t know of other professional groups or journals with similarly stringent disclosure rules.

As to whether mere disclosure is enough to deal with conflicts of interest, she said it is at least a first step to ensure “that these things are addressed.”

Catherine D. DeAngelis, editor in chief of the Journal of the American Medical Association, said she knows of no other such policy. But she noted that she and other top medical-journal editors plan to discuss it at a June meeting.

“I’m sure this is because of Sen. [Chuck] Grassley,” she said, referring to the Iowa Republican who has disclosed millions of dollars paid by medical companies to leading doctors. “I’m sure they’re saying we’d better police this ourselves or the feds will.”

“This initiative is impressive because of the sanctions it contains for violating the society’s own code,” said Sen. Grassley.

In recent years, medical-implant makers Zimmer Holdings Inc., Stryker Corp., the DePuy orthopedics unit of Johnson & Johnson, and Biomet Inc. have paid more than $221 million to surgeon “consultants,” according to a Senate committee.

Medtronic Inc. has been accused by former employees and the government of inducing surgeons to use its spine products through questionable payments. In 2006, the Minneapolis company agreed to pay $40 million to the government to settle civil charges in federal court in Memphis, Tenn., that it paid kickbacks to doctors, but denied wrongdoing.