Lilly funds 60 Boston docs

From The Boston Globe:

lilly logoAt least 60 Massachusetts doctors collectively have earned more than a half-million dollars this year as speakers paid by pharmaceutical giant Eli Lilly & Co. – including two Boston Medical Center physicians whose participation is being reviewed for possible violation of a hospital policy against marketing activities by its doctors.

After learning of the doctors’ company-sponsored talks from the Globe, Boston Medical Center said it would investigate the matter and directed the physicians not to make any further presentations on behalf of Lilly in the meantime.

So much for internal disclosure. More from the Globe:

bmcLogo1[1]The use of physicians in speakers programs or “bureaus’’ like Lilly’s, in which doctors generally use company-prepared materials to explain a drug’s uses and dosing to their colleagues, is widespread in the drug industry. But the practice is under growing scrutiny and some academic medical centers are barring their doctors from participating, believing that physicians essentially become hired advertising guns, with weakened credibility.

10/1 update  The Wall Street Journal reports on new industry authorship guidelines from PHRMA.

 Here are a few interesting details, followed by a big grain of salt:… The guidelines are purely voluntary.

Also see today’s Globe editorial and letters both for and against industry support.

 WCVB Channel 5 in Boston also reports.

 Health reformers at Boston’s Health Care for All commented on their blog. So did Gooz News. 

 Here’s the Lilly list of company funded docs.

 Note that Lilly was not a big supporter of the state’s ban on pharma junkets for docs. From the Boston Business Journal.

 The head of pharmaceutical giant Eli Lilly & Co. on Friday blasted a new law governing how drug companies market to physicians, calling it a bad move that will hamper innovation and force companies to reconsider expanding in Massachusetts.

Still, it didn’t stop the biotech industry from planning their annual meeting here — for the second time in three years — as announced yesterday.

For more on critics of pharma sponsorship of doctors, see the Integrity in Science Project.   

For more on docs who want to be free to work closely with industry, see the webcasts and slides from July’s inaugural meeting of The Association of Clinical Researchers and Educators (ACRE) an “organization of medical professionals who recognize that appropriate physician-industry collaborations and relationships benefit patients and advance science.”  Also note BHN’s reporting from the meeting, which took place at Brigham and Women’s Hospital.   

 At that meeting, Dr. Carey D. Kimmelstiel,head of clinical cardiology at the Tufts University School of Medicine, talked about the benefits of having clinicians give industry-sponsored talks. Preparing the talk educates the speaker. He or she gets feedback and an audience of busy docs gets a quick update. He did say some of the transparency are good because it discourages clinicians from showing company-produced slides without really understanding them.

 But he believes the law has constrained continuing medical education by limiting the “the only reliable source of such funding, which is industry.”  

 Click here for his full statement and all of the presentations at the ACRE meeting.

9/30 The Wall Street Journal reports on new industry authorship guidlelines from PHRMA.

 Here are a few interesting details, followed by a big grain of salt:… The guidelines are purely voluntary.

Mass residents still like the state’s health insurance program

…just not as much.

Support for the program has actually dropped a bit. This from a Globe/Harvard poll.

Public support for Massachusetts’ closely watched health insurance overhaul has slipped over the past year, a new poll indicates, but residents still support the path-breaking 2006 law by a 2-to-1 ratio.

The comments on this sound like a town hall meeting — except no on had to show up. There are the ranters. There are resonable critics of the plan but you won’t find many here, at least not by 8:20 a.m.  My favorite — God is against it.

Which is to say, they put off solving the actual problem for a resume-padding scam of a system, designed by people who all already had excellent health insurance..

We pay more and wait longer than any other state. And this is what Obama wishes to unleash on the rest of the unwilling “bitter clingers”. (sic)

Meanwhile, the program is bankrupt, the people being forced to buy coverage are bankrupt – but the insurance companies get rich and the politicians get to say they are doing something good. This is an obscenity.

 

The decaying support for the Massachusetts health initiative is pale in comparison to the boondoggle being fashioned in Washington. Those that REALLY love it still thinks it’s something for nothing. Just wait until these hacks on Beacon Hill try to raise even more taxes for the inevitable shortfall. Universal Healthcare = Cruel hoax.

 

I don’t like it and I’m tired of paying for other people’s insurance. 

And if for religious reasons the insurance is unacceptable, well since our GOD doesn’t approve it, we won’t have to pay the penalties either. I’m waiting for doctors and school teachers to be paid the same.

Infectious disease and Bostonians from Africa

Passing this along from the Running a Hospital blog, which is run by BIDMC chief Paul Levy. 

According to World Health Organization reports, nearly half of deaths due to infectious diseases globally, occur in the Sub-
Saharan Africa. Particularly, of all the people infected globally
by various diseases, 89% of those infected by malaria, 77%
of HIV/AIDS patients and 31% of Tuberculosis patients, in Sub-Saharan Africa die of these diseases.

There is a large population of Sub-Saharan Africans domiciled
here in Massachusetts.
The African Community Health Initiatives
(ACHI) has stepped up to help, not only to provide appropriate
education, but has increasingly become a conduit through which
people of African descent are sought after, screened for health
insurance, health/social service needs, and assisted with application/referral to appropriate health/social service providers.
ACHI also assists in the enrollment of clients in the Massachusetts state health insurance plans, namely, MassHealth and Commonwealth Care.

Kennedy aide to serve in Senate until Jan. election.

Eugena Ossi / Governor's Office

Eugena Ossi / Governor's Office

Long-time Kennedy aide Paul Kirk will replaces his late boss until the special election in January

For impact on health bill, see Globe politics blog.

The Duke weighs in.

For more on Kirk, also from the Globe

(Massachusetts Governor Deval) Patrick has remained mum about his selection, but Kirk entered the governor’s office through a side door at about 10 a.m. He was joined a short time later by the late senator’s wife, Vicki Kennedy, and his son, Ted Kennedy, Jr. Patrick is scheduled to announce the appointment at a press conference later this morning at the State House.

 …An attorney who now lives on Cape Cod, Kirk worked as a special assistant to Senator Kennedy from 1969 to 1977 and is currently the chairman of the John F. Kennedy Library Foundation. He is familiar with many on Kennedy’s former staff and could help smooth the transition.

Kirk was registered as a lobbyist a decade ago. He was paid $35,000 to represent the pharmaceutical company Hoechst Marion Roussel on legislation before the US Senate in 1999, according to federal disclosure records. He is currently on the board of directors of the Hartford Insurance Group.

From Politico

Ghost writing at NEJM

The Globe’s White Coat Notes reports thatThe New England Journal of Medicine is disputing “findings from a rival journal’s survey that says there were more ghostwritten articles at the Waltham-based publication than at five other prominent journals.

“We take matters of authorship very seriously,” New England Journal spokeswoman Jennifer Zeis said in an e-mailed statement. “We are persistent and vigilant in communicating our policies, and we hold authors accountable for their work.”

This from 9/11 Science News.

VANCOUVER, B.C. Journal articles often list a long string of putative authors. I once counted 47 on a physics paper. But where journal articles in the natural sciences often appear overly conscientious about acknowledging all contributors, the opposite has become a nagging problem in biomedicine. Here, not all authors on a research project – or even, necessarily, the most important ones – may be identified as a contributor.

The existence of these ghost authors, as they’re called, evoked frustration and anger yesterday in a large share of the 400 journal editors and clinical research scientists taking part in a quadrennial international workshop on peer review and biomedical publication.

Click here for a science writer’s point of view.

UPDATE: 9/26 Click here for a story from the Guardian about a recent case in the UK.  The Health Care Renewal blog has been all over this one, and the topic of ghostwriting in general.

Caution or stubbornness? Boston docs shun new heart procedure

longwood mapBoston-area docs are known for their reluctance to adopt new procedures. The Washington Post reports that holds true for a new approach to angioplasty. Instead of steering the catheter into the coronary arteries through the groin, some docs go through the wrist.

Questions about the best method of performing cardiac catheterizations, one of the most common procedures in medicine and among the most profitable for hospitals — Medicare reimburses (George Washington University) GWU about $10,600 for an angioplasty involving one stent — reflect some of the issues in the roiling health-care debate. Is the radial approach, which has a steep learning curve, actually superior or largely a fad? Can it cut costs by reducing hospital stays? And if patients are given a choice of catheterization sites, what factors should they consider? …

In Boston, a city brimming with teaching hospitals and interventional cardiologists — heart specialists with advanced training who perform procedures — only a handful of physicians specialize in radial catheterization, said Pinak B. Shah, director of interventional cardiology training at Brigham and Women’s Hospital.

“There’s no data out there to suggest it is worse and growing evidence that it may be better,” said Shah, an assistant professor of medicine at Harvard Medical School, who performs 60 to 70 percent of procedures through the wrist.

Shah said he believes a combination of financial self-interest, the relative paucity of medical devices designed for radial access, resistance by older physicians and the general tendency of doctors to regard patient discomfort as secondary have contributed to under-use of the approach. 

 

Minnesota looks at the Massachusetts mandate

star journalGreetings fellow lab rats. Read on from the Minneapolis Star-Tribune:

Democrats highlight the expansion of coverage; about 97 percent of Massachusetts residents have insurance, compared with 85 percent nationally. Republicans, including Minnesota Gov. Tim Pawlenty, ding it for spending too much; Massachusetts had to scale back its coverage goals this year in the face of a big state budget deficit.

Health experts, meanwhile, consider it a useful laboratory to study the effects of revamping the health care system.

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