Doctors’ lucrative relations with device companies revealed

At PLoS Medicine we routinely examine conflicts of interest associated with the health influence of industries such as pharma, tobacco, and alcohol. We’ve published rather less on medical devices (this article is a notable exception), but two new journalistic pieces suggest we should do more. The sheer scale of the money changing hands, and the conflict of interests it implies, is jolting.

Last month I was interested to learn from a USA Today article by ProPublica journalists that medical societies like the American College of Cardiology, American Society of Hypertension, and Heart Rhythm Society received millions of dollars from drug and device companies for “promotional opportunities” but also in exchange for access to doctor members including the use of tracking badges that could provide real-time data to the company to “learn about who visited their booths, including names, job titles and how much time they spent.”

The Heart Rhythm Society, comprised of just 5100 members, represents a particularly lucrative market, says the article:

One implantable cardioverter defibrillator — a device that jolts the heart back to a normal beat — can cost more than $30,000…. World sales of the devices totaled $6.7 billion last year…. All the defibrillator manufacturers are at this week’s conference, including market leaders Medtronic, Boston Scientific and St. Jude Medical, which together gave the society $4 million last year.

What’s more, two-thirds of the Heart Rhythm Society’s board members are paid speakers or consultants for the companies, says the article.

Today, another article, this one in  The New York Times, reports how one group of medical specialists has had enough, devoting an entire special issue of their society’s Spine Journal to publicly denounce the research of other experts supporting the growth and use of a Medtronic bone growth product used with implantable devices for spinal fusion.

The article says that “The median amount of Medtronic money received over time by researchers involved in some studies ranged from $12 million to $16 million, with most of that going to a few individuals,” and noted that one doctor from Wisconsin had received over $20 million in royalty payments from Medtronic in connection with patents on devices.

The article quotes an editorial in the journal written by five doctors (the journal is not freely available): ” It harms patients to have biased and corrupted research published….It harms patients to have unaccountable special interests permeate medical research.”

“An obvious and enormous conflict of interest,” indeed.