When Massachusetts health system Partners Healthcare announced new industry interaction recommendations for doctors on Friday, it was just the latest piece of erosion in the changing landscape of the healthcare-pharma relationship. The recommendations came days after a similar announcement from Johns Hopkins and one month after Partner's home state set statewide rules limiting pharma gifts to physicians.
Although these new policies may seem like an onslaught on the pharmaceutical industry, Partners says they put their policy in place to make the symbiotic relationship stronger.
“I think there are many important aspects of the relationships between academia and industries that we need to preserve and protect," says Peter Slavin, MD, the president of Massachusetts General Hospital, who is leading the implementation efforts across Partners. “It's in our interest and in the public's interest that we focus our relationship with these issues and try to eliminated some of the noise that cause some people to call into question the value of the [pharma-healthcare] relationship. I think it will make the relationships stronger and by working together it will help the people we're trying to serve."
Extravagant dinners and ghostwritten articles are unnecessary distractions, while drug research and trials are paramount, he says.
Similarly, the Johns Hopkins policies were written to prevent any aspects of marketing from getting involved with drug research and physician interaction.
"This policy is designed to try to put the emphasis on relationship with industry—where many people believe it should be," says Julie Gottlieb, assistant dean for policy coordination at Johns Hopkins University School of Medicine. "That [focus] is on science and medicine exchanges that will advance patient care—and not on marketing."
Ideally, these conflict-of-interest policies will create strong ties that better facilitate the exchange of ideas between healthcare organizations and pharma researchers, she says.
“Ultimately none of us want to see a situation were our medical care is compromised because of a financial relationship between pharmaceutical company and that doctor," says Retta M. Riordan, president of Riordan Consulting in Mountainside, NJ and former compliance officer for Organon BioSciences. “Similarly we don't want to see the results of a research doctor being swayed as a result of the relationship. It would be horrendous from a research standpoint, a patient standpoint, and a company standpoint."
But the most recent regulations, like those implemented by Partners and Johns Hopkins, have gone too far, Riordan says.
“What has happened is these conflict-of-interest policies have been morphing into much more," she says. “They basically have been looking at every contact with pharma as being bad. I think these extremely restrictive policies don't benefit anyone, least of all the patient."
Slavin admits that the new Partners policy has caused dissent in the pharmaceutical industry and even within the organization itself, but they are prepared to deal with the consequences.
“We really feel very strongly that relationship between Partners and industry is critical to us achieving our mission," he says. “By restricting certain things they will liberate us to focus more energy on the important things between our organization and industry."
The next step for Partners will be to turn broad recommendations into specific policies ready for implementation.
“I hope by working together we can develop new agents that can help the lives of our patients and the public in general," he says. “I hope in five years from now this is less of a concern to public policy members, the media, and the public at large."
Johns Hopkins is less optimistic about the future of the healthcare-pharma relationship, and it will adjust its policies as the environment changes, Gottlieb says. "If industry decides to find new and different ways to market their products that also undermine independent decision making by physicians and researchers, then we have to address those," she says. "I hope that's not the case."
Riordan, too, is thinking about the future.
“We may see some more of these restrictive policies coming on board," she says. “What we don't want to see is a total restriction on interactions between physician and drug companies. I think people have stepped over a little too far in one direction, but I'm hoping that the pendulum will swing back."