Sunday, January 6, 2008

More on Device Kickback Deals

Roy Poses' Health Care Renewal blog has very kindly cross-posted a couple of my recent entries on this blog, so now I need to return the favor by calling your attention to his excellent summary (click the link below and look for the entry dated January 4 and titled, "Neurosurgeon Admits Kickbacks from Medical Device Manufacturers"):

I offered my views a while ago ( on how devices were different from drugs in a couple of ways, that made it seem less reasonable to completely ban device reps from the hospital the way that many medical centers are now banning drug reps. While, if anything, leaning over backwards to try to be open-minded to what device reps might bring to the patient care arena that would uniquely benefit patients, I felt obligated to add the comment regarding the payments/gifts received by physicians from device reps: "at least some of these payments, if not the majority of these payments, are thinly disguised bribes to use the drug/device rather than an equally good drug/device made by a competitor company."

Dr. Poses offers excellent reasons in his summary as to why we should view the case of the neurosurgeon, Dr. Chan, as a tip-of-the-iceberg case rather than as a single-rotten-apple case--suggesting that kickbacks and bribes to surgeons for using one company's implanted devices are 1) very widespread, and 2) very commonly "disguised" as consulting fees and research grants.

I know this is no sort of controlled trial, but as I recall the various news accounts I have read over the years about docs who receive excessive gifts from drug reps in exchange for prescribing a certain company's drug, and contrast the stories about device manufacturers paying our similar bribes, the rule seems to be to take the amount of the drug company payoff and add a zero at the end of the figure, and you get the amount of the device company payoff. I don't know if that means that the device industry is that much more lucrative and so the companies can afford pricier kickbacks; or that surgeons make so much more money that it takes a bigger kickback to get their attention; or (more likely) both.

No comments: