The primary expose is of the Heart Rhythm Society, a group that has gone from 38% corporate sponsorship to 50% between 2006 and 2010, totaling $4 million last year. During this same time we've seen an explosion in the insertion of implantable cardiac defibrillators (ICDs), primarily in older adults. An ICD can cost more than $30,000. World sales of ICD's totaled $6.7 billion last year. 12 of the 18 board members of the Heart Rhythm Society are paid speakers or consultants for ICD manufacturers.
At the annual meeting of the Heart Rhythm Society, going on right now in San Francisco, Medtronic has a 12,000 square foot booth, and Boston Scientific has a 8,100 square foot booth. These ICD makers paid $1.6 and $1.5 million respectively to advertise at the 2010 annual meeting.
I don't usually read USA today. But I read it today because I'm not in San Francisco, where I live, I'm in Phoenix, at the annual meeting of a professional society of physicians that has taken a decidedly different approach to corporate sponsorship: the Society of General Internal Medicine (SGIM). The USA today was outside my hotel room door. SGIM, I am proud to say, does not accept corporate sponsorship.
The American Geriatric Society (AGS) and the American Academy of Hospice and Palliative Medicine (AAHPM)/Hospice and Palliative Nurses Association (HPNA) do accept corporate funding for their annual meetings. At one recent AGS meeting, you had to walk through giant annoying sponsor booths in order to reach the poster session. The meeting costs are about the same at SGIM, AGS, and AAHPM, about $500-600 for a 3 day meeting.
Why might corporate sponsorship of clinicians and medical societies be problematic?
- Steinman and colleauges surveyed medical residents, finding that a majority of them didn't believe corporate sponsorship of lunches and pens contributed to their prescribing practices. These same residents overwhelming believed that practicing physicians are influenced by corporate sponsorship. In other words, "sure it has an effect, but not on me!"
- Chuck Grassley, the top Republican on the senate judiciary committee, says he doesn't believe doctors are unaffected, "There are a lot of incestuous relationships that really bother me." Senator Grassley is pushing for mandatory disclosure of corporate sponsorship of professional societies.
- Cardiologists movements were monitored at a recent annual meeting using radio frequency tags ID tags in their conference badges. This information is sold to industry sponsors who exhibit at the conference, presumably in aggregate, detailing what sort of person visited your booth, for how long, etc.
- Corporate influence on the development of Guideline recommendations for hemoglobin targets in dialysis patients (sponsored by the makers of Epo) and hemoglobin A1c targets (sponsored by the makers of Lantus) was described in this GeriPal post.
- Pfizer, the drug company that makes the epilepsy drug Neurontin (gapabentin), had to pay $142 million in racketeering charges for marketing this drug to physicians for off-label prescriptions, including pain. See Steinman's careful analysis of internal company documents here.
by: Alex Smith