Wednesday, September 24, 2008 | Categories: Dr. Brian's Blog
The New York Times has a story today about drugmaker Eli Lilly's announcement that from now on, it will publically report on all payments to outside doctors for speaking and consulting services. According to the Times, the company's chief executive announced that beginning in 2009, it intends to post "all its payments to doctors in an online database. The posting will "likely include" the name of the doctor or some other identifying information, along with the reason for the payment, the company said."
This voluntary move follows efforts by the US Congress to establish a national registry of such payments to physicians. A bipartisan bill called the Physician Payments Sunshine Act is expected to be taken up next year. Other pharmaceutical companies say they plan to follow Eli Lily's lead in the next few months.
The idea behind disclosing such information is the fear -- backed by some evidence -- that money from Big Pharma can taint doctors' prescribing habits, their research, and even their clinical judgement.
In the interests of FULL DISCLOSURE, yours truly has given lectures and seminars to MDs that were paid for by pharmaceutical companies. Now, I certainly hope that the talks I've given under those circumstances were fair and unbiased. In the vast majority of cases, the content of my talks has been accredited independently through third party agencies such as the College of Family Physicians of Canada. The purpose of these seminars is educational. Many doctors on both sides of the lectern find these talks extremely useful in helping keep them up to date on the latest developments.
Have I ever been corrupted by money? I'd be awfully precious if I said no, now wouldn't I? One way or another, we're all corrupted by lucre.
In my opinion, the key isn't the corruption. It's the disclosure of competing interests.
The idea of full disclosure is not new. These days, health professionals who submit proposals to do lectures are obligated to disclose any completing interests -- especially whether or not they receive funding from drug companies. The same goes whenever they submit research for publication in medical journals. More recently, provincial Colleges have developed competing interest policies which bind MDs to disclose to patients any relationships with pharmaceutical or other companies that might affect the drugs they prescribe or the treatments they recommend. Disclose these competing interests, and people are free to accept or reject what you have to say.
Full disclosure by pharmaceutical companies themselves is a good step in the right direction.
I applaud efforts by Eli Lilly and other companies to carry disclosure to the next level.
So, time to put my money where my mouth is. From now on, I promise to disclose in this space whenever I give a talk that has anything to do with Big Pharma.
On Sunday October 6, 2008, I'm hosting and speaking at a satellite symposium at the Scientific Assembly of the BC Chapter of the College of Family Physicians of Canada. The title is "Introduction to Chronic Pain Management and the Power of Storytelling". The program has been accredited by the BC Chapter of the College of Family Physicians of Canada. The funding for my talk is through an unrestricted grant from Purdue Pharma, a pharmceutical company. My fee for giving the talk is $2000.00. The fact of the grant was reported to the BC College of Family Physicians prior to accreditation. However, to my knowledge, this is the first time any doctor I know has disclosed publically how much he or she is being paid to give a talk.
See? Didn't hurt a bit! I challenge all of my colleagues to do the same from now on.