Massachusetts Physician Disclosure: The Exemption for Research Makes Sense

Peter Pitts from the Center for Medicine in the Public Interest had this editorial in The Boston Globe over the weekend:

Amid concern that money from drug makers was unduly influencing medicine, Governor Deval Patrick recently signed a law aimed at shedding light on the relationships between pharmaceutical firms and healthcare practitioners.

The Department of Public Health, which is responsible for enforcing the law, recently submitted the regulations it plans on implementing to the Public Health Council, which will vote on it in February.

Along with banning certain gifts, the new regulations would require pharmaceutical companies to disclose payments above $50 made to doctors, scientists, and other medical professionals.  This information will be posted on the internet.

The Department of Public Health has decided, however, to exempt medical research funding from the disclosure requirement.  This move should be applauded, as it protects

Massachusetts' thriving pharmaceutical industry and ensures that patients receive the best possible care.  The Council should vote to make the exemption official.

Transparency is a good thing, of course, so lawmakers' efforts to ensure that patients know about financial ties between drug firms and healthcare providers are understandable.  Indeed, this move came on the heels of a similar step by the pharmaceutical industry itself, which issued strict new rules governing how drug representatives pitch their products to physicians.

Such restrictions, however, should be limited to a company's marketing efforts.  Funding for medical research is a different matter.  Many of

Massachusetts' leading academic labs are conducting research in partnership with pharmaceutical companies.  Drug development depends on this sort of cooperation.

Further, forcing pharmaceutical firms to disclose information about research funding implies that there is something wrong regarding the practice.  Consequently, the doctors and scientists who receive research support from drug firms could be stigmatized.  Fearful of jeopardizing their reputations, this could motivate many to leave the state and give-up on their research projects.

This would make a bad situation even worse.  According to the Massachusetts Medical Society, nearly one-quarter of practicing physicians either already have plans to leave the state or are considering leaving because of burdensome regulations.  This number should send chills down Bay State legislators' spines.

Massachusetts' pharmaceutical firms employ approximately 55,000 workers.  Between 2000 and 2005, the state lost nearly 100,000 private-sector jobs, but the pharmaceutical industry created over 6,000 new positions.

There are more than 5,000 drug trials being conducted in Massachusetts, making the state one of the country's leaders in medical research.  But just like beleaguered doctors and scientists, Massachusetts' pharmaceutical companies could decide that the state's regulatory environment has grown too hostile and move elsewhere.

Onerous regulations also add to a company's operation costs.  Such costs eat-up research budgets – choking off investment dollars into new drugs and treatments – and get passed on to consumers in the form of higher drug prices.

Instead of making life harder for pharmaceutical firms and the medical profession by mandating public disclosure of research grants, the Commonwealth should be looking to make life easier for such a valuable sector of the economy.

Peter J. Pitts is President of the Center for Medicine in the Public Interest and a former Associate Commissioner of the FDA.

Bizarre Comment

Of course, in what could be considered a bizarre response, professional trial expert witness, David Egilman M.D., M.P.H. wrote a detailed rebuttal – not of the arguments that Peter makes – but of the fact that Peter did not include all his jobs, including his day job as Senior Vice President at Manning Salvage and Lee.   

Dr. Egilman’s disclosure was also guilty of the same sin that he accused Peter of – that of his own conflicts of interest.

Dr. Egilman wrote (verbatim): “I have consulted in litigation at the request patients injured by drugs and devices and at he request of companies who have been sued by people claiming injuries form prodcut exposures. This response is not part of my regualr work and my tiem was uncompensated,” (intentional misspellings as found in original comments).  This response downplays the 20-25 million dollars that Dr. Egilman has earned from being an expert witness, often in cases of which he he has little background in that therapeutic area.

Boston Globe: Recognizing Drug Firms' Role in Research