Wednesday, October 20, 2010

New Merck Comes Up "Short": Of Best Current Practices -- On Vetting Its MD Speakers

Many readers have no doubt noticed the ProPublica website's handy (and stunning) compilation of pharmaceutical companies' paid-speakers data-bases, as well as the on-going series of stories that make plain many of the current failings in this non-system. For example, over just the last two quarters, Merck has made payments to over 1,700 medical speakers, aggregating over $9.4 million, in such fees alone. Merck's quarterly payment burn-rate is now about $4.7 million. Wow. [We've been following this emerging set of conflicted-speaker problems since late 2008.]

What is at stake here is whether ordinary patients are aware that their own doctor may have been influenced to prescribe a specific drug, by another doctor -- more than occasionally, a doctor not even qualified in the relevant specialty area -- a doctor who is also receiving multiple hundreds of thousands of dollars each year, to fly around and (subtly, or not so) tout a specific drug. A drug like Merck's Vytorin® -- for example. In four years ending in 2009, legacy Schering-Plough and Merck ran-through an additional $60 million on "continuing medical education" expenses.

As a follow-on story, tonight, ProPublica is running a compendium of what the various pharma majors (including Merck) at least say they do -- to weed out unqualified, or unethical, speakers. Significantly, a few companies, like GlaxoSmithKline, at least say they screen the state disciplinary board databases on a monthly basis -- against their "under contract" speakers' databases. Merck does only annual checks against the state board's database:

. . . ."As part of our evaluation of potential speakers, each candidate must review and agree to the terms of the Speaker/Moderator Agreement Letter which includes: 1) Confirming that speaking at a Merck program would not raise a conflict of interest; 2) Reporting to Merck if they are excluded from certain government programs; and 3) Merck's right to terminate a speaker's agreement for unethical behavior. We also check all candidates against the U.S. government's Excluded Parties List (EPLS), Office of Foreign Asset Control (OFAC) and Office of Inspector General (OIG) database."

A spokesman said the company does not routinely check physicians against state board websites. "We do background checks at the time we contract and then annually. We are currently evaluating our processes and expect to take additional measures beginning in 2011. . . ."

Better make that double quick. This meme is blooming all over every media outlet.

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