Doctors Given Millions by Device Makers Fail to Disclose Pay in Research

Fewer than half of the physicians who received $1 million or more in consulting fees from medical device companies including Johnson & Johnson, Stryker Corp. and Biomet Inc. in 2007 disclosed the financial ties in subsequent articles they wrote about the industry, a study shows.

Investigators analyzed a database of payments from J&J’s DePuy unit, Stryker, Zimmer Holdings Inc., Biomet and Smith & Nephew Plc, and cross referenced their findings with disclosures on medical journal articles written by the top-paid consultants, according to the report released today in the Archives of Internal Medicine. They focused on 40 orthopedic surgeon researchers given at least $1 million from a single company and another who received that much from two companies. The biggest payout was $8.9 million.

Harvard, Columbia and Stanford medical schools are among the universities that have increased reporting requirements for faculty members who consult with drug and medical device companies in light of concerns about conflict of interest. J&J, based in New Brunswick, New Jersey, New York-based Pfizer Inc., the world’s biggest drugmaker, and Medtronic Inc., the largest maker of heart devices based in Minneapolis, are among the companies that say they disclose payments to physicians.

“The system is broken if you can’t follow million-dollar payments to physicians by companies, and that’s the situation,” David Rothman, the senior author of the paper and president of the Institute on Medicine as a Profession in New York, said in a telephone interview. “If someone is getting $1 million in connection with a product that he or she is writing about, it’s something a reader needs to know.”

Limited Disclosure

The doctors published 95 articles related to the companies in 2008, the year following their payments, including studies, reviews and analyses designed to influence the future of patient care, according to the report. Fewer than half of the studies, just 44, disclosed the industry payments. Only seven of the publications gave any information about the actual sums -- all stating the author received more than $10,000.

It’s not clear if the doctors failed to disclose their fees to the medical journals, or if the journals decided not to publish the information, Rothman said. The study raises questions about the quality of the research into medical devices, which may lead to biased scientific conclusions, he said.

$184 Million

The five companies overall made 985 payments to doctors for a total of $184 million in 2007 for consulting services, honoraria or assistance related to hip- and knee-replacement and reconstruction, with an average payment of $187,000, the institute researchers found. The Institute on Medicine as a Profession is a research group based at Columbia University College of Physicians & Surgeons in New York.

Almost all of the subsequent articles were related to devices made by the companies, such as a hip or knee implants. Even when the report stemmed from the fees paid by the company, the researchers disclosed the payment just half the time. Disclosure rates rose to 54 percent when the researcher was the first, only or senior author of the paper, the study found.

As part of the Patient Protection and Affordable Care Act, drug, device and medical supply companies are required to list payments worth $10 or more to doctors in a public database that can be easily searched by 2013.

“The next generation of physicians should know that every nickel they take from industry is going to be made public,” Rothman said.

To contact the reporter on this story: Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net

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