Senators To Seek Registry of Pharmaceutical Gifts

Senate Special Committee on Aging Chair Herb Kohl (D-Wis.) and Sen. Claire McCaskill (D-Mo.) at the end of a hearing on Wednesday said that they will seek legislation to establish a national registry of gifts and payments from pharmaceutical companies to physicians, the New York Times reports (Harris, New York Times, 6/28).

The hearing "examined a wide array of drug industry practices that witnesses described as influence buying," but Kohl "stuck largely to the idea of creating a national registry ... as his policy prescription for problems raised at the hearing," CQ HealthBeat reports.

In his opening statement, Kohl said, "It has been estimated that the drug industry spends $19 billion annually on marketing to physicians in the form of gifts, lunches, drug samples and sponsorship of education programs." He added, "These gifts and payments can compromise physicians' medical judgment by putting their financial interest ahead of the welfare of their patients."

At the hearing, J. Gregory Rosenthal, chief of ophthalmology at Toledo Hospital in Ohio and a founder of Physicians for Clinical Responsibility, said that some physicians "are literally trading independent medical integrity for corporate profits."

Rosenthal said, "This inappropriate influence ... has created a schism in the retinal community between the majority of retinal docs who want to take optimal and cost-effective care of their patients and the growing minority of strategically cultivated doctors willing to help corporate interests in exchange for valuable consideration of various sorts."

Robert Sade, who testified on behalf of the American Medical Association, said that "there is a clear need for interactions between physicians and the pharmaceutical industry," adding that gifts from pharmaceutical companies accepted by physicians should "be related to the physician's work" (Reichard, CQ HealthBeat, 6/27).

Jerome Kassirer, a medical professor at Tufts University, said, "These marketing efforts are thinly disguised bribes" (Hoffer, Milwaukee Journal Sentinel, 6/27).

Kassirer said that the Institute of Medicine should conduct a study of potential conflicts of interest prompted by the gifts and payments from pharmaceutical companies to physicians.

Kassirer said that, although he supports a registry of such gifts and payments, the "problem is the conflict," adding that "disclosure doesn't solve the conflict."

Marjorie Powell, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, said that the differentiation of "gifts" and "marketing" in such a registry would prove difficult. She added, "It's important to recognize that all of what pharmaceutical companies convey to doctors is already thoroughly regulated."

PhRMA Senior Vice President Ken Johnson cited problems with such registries in Minnesota and Vermont that he said "do not recognize that safeguards already exist to make sure the information provided by company representatives is accurate and well-substantiated" (CQ HealthBeat, 6/27).