This week there have articles, commentaries and statements flying around due to the release of the Institute of Medicine Report on Conflict of Interest, in Medical Research, Education and Practice.

Some of the Key quotations include:

PhRMA:  Statement on Institute of Medicine Report

Throughout the report the IOM writers elude to a misnomer that the major expense at pharmaceutical companies are devoted to marketing than research, as a basis for their recommendations.   This statement may be true of the IT industry but nor reflective of pharmaceutical companies.

PhRMA’s statement clarifies that “America’s pharmaceutical research companies spend far more on research and development (R&D) than on marketing. In 2007, pharmaceutical companies invested $63.2 billion on R&D of new medicines, while spending around $11.5 billion on promotional activity directed to physicians, journal advertising and consumer advertising, according to IMS Health. Last year, pharmaceutical companies spent a record $65.2 billion on R&D.

“According to the Congressional Budget Office (CBO), America’s pharmaceutical research companies are ‘one of the most research-intensive industries in the United States.’ Pharmaceutical firms invest as much as five times more in research and development, relative to their sales, than the average U.S. manufacturing firm, CBO states. 

Recommendations by IOM and others can also help advance ethical, professional relationships.  But it is important to balance the need to manage potential conflicts of interest against the possibility that overly restrictive policies – for example, prohibitions on physicians’ use of drug samples or on the availability of industry funding for CME – could have negative consequences for patient care.”

Senator Grassley:  Institute of Medicine Report on Conflict of Interest

“It’s a shot in the arm to the reform movement to have the prestige and policy heft of the

Institute of Medicine on the side of transparency.  The more disclosure, the better, for holding the system accountable and building public confidence in medical research and practice.”

New England Journal of Medicine: Controlling Conflicts of Interest

This is an extremely pro-regulatory article and the Author Robert Steinbrook, who presented before the IOM committee, does a good job summarizing the report at the end, you can tell that he is hopeful that many of the recommendations though conflicted (the committee kept going back and forth in the document) will be adopted.

Although specific recommendations may be criticized as either too strong or too weak, the IOM's overall proposals are comprehensive and — if adopted — would most likely have substantial effects on individual physicians and medical institutions. However, there has been no shortage of previous reports and calls for change; the new report lists 16 of the "more prominent reports" that were released between 2001 and 2008 alone. So the institute's proposals could merely provide more fodder for discussion — or perhaps mark a turning point in controlling conflicts of interest in medicine.

New York Times: Institute of Medicine Calls for Doctors to Stop Accepting Gifts from Drug Makers

Of course Gardiner Harris of the New York times came out with an article that the IOM report represents vindication for all things anti industry collaboration

In a scolding report, the nation’s most influential medical advisory group said doctors should stop taking much of the money, gifts and free drug samples they routinely accept from drug and device companies.

One interesting note is the quote from David Rothman:“With the I.O.M.’s endorsement, issues that were once controversial now are indisputable,” said Dr. David Rothman, president of the Institute on Medicine as a Profession at Columbia University. “Conflicts of interest in medicine are no longer acceptable.”

The opening sentence of the IOM report states:  Patients and the public benefit when physicians, researchers, collaborate with pharmaceutical, medical device and biotechnology companies to develop products that benefit individual and public health.

This is not exactly the same sentiment that Dr. Rothman portrays, he has staked his living on the COI debate for years, they did not go for the sever restrictions he has been calling for, perhaps this is a wakeup call that even Ethic’s purists can come to the same conclusions that he has in his Institute of Medicine as Profession reports, notice he uses a similar sounding name as IOM just to give himself more credibility, never quite getting to the truth.

Wall Street Journal: Institute Urges Strict Curbs on Medical Industry Perks

The Institute of Medicine recommended Tuesday that doctors, medical schools, professional groups and drug makers make far-reaching changes to prevent industry gifts and payments from influencing patient care and research.

Thomas Stossel, a professor at Harvard Medical School, criticized the proposal to cutback industry funding of doctor education because it would deprive physicians of a valuable source of up-to-date information about valuable treatments.

"There is no evidence for the need of these regulations," said Dr. Stossel, who said he has started companies and worked with industry. "It's high-end welfare for the ethicists and maybe job security for the academic administrators," he added.

Associated Press: Medical experts want crackdown on drugmaker money

Millions of dollars in gifts, travel and consulting fees from the pharmaceutical industry should be eliminated to stop companies from influencing how doctors practice medicine, a report by the government's top medical advisers says.

The sweeping recommendations from the Institute of Medicine call on medical professionals — from university professors to family doctors — to shun financial arrangements with companies that have flourished over the past three decades.

Taking free lunches from company salespeople, giving paid lectures on their behalf and other practices "erode public trust while providing no meaningful benefits to patients or society," institute panel chair Dr. Bernard Lo said in a statement.

The report calls on medical schools, hospitals and physician groups to:

• Publicly report funding they receive from companies.
• Not accept free meals, gifts or other items from companies.
• Prohibit doctors who have a financial conflicts of interest from testing new therapies on people.

Perhaps the most vigorously defended practice is company support for so-called continuing medical education conferences, where doctors learn about the latest treatments. Most state medical boards require physicians to attend a certain number of sessions each year to maintain their licenses.

While the panel stopped short of calling for a ban on industry-funded education, it stated that "a new system of funding … should be developed that is free of industry influence

The AP story is accurate in the visceral nature of the press conference.

Jack Lewin, MD Chief Executive Officer of the American College of Cardiology was Quoted in every article:

"The acceleration of science is going to make it tougher and tougher for physicians, nurses and other health care professionals to stay current," said Dr. Jack Lewin, President of the American College of Cardiology.

In addition there is a great interview with Dr. Lewin and story on MedPage Today, I think he is leading the charge at medical societies to make changes that don’t hinder the advancement of science and risk patient care.