MedStar hospitals received more than $1M from drug cos. in 2013

Last November, MedStar Health’s Washington Hospital Center received $300,000 from pharmaceuticals giant Abbott Laboratories in the form of education grants. A month later, it received grants from both Boston Scientific and MedTronic worth $225,000 and $215,000, respectively.

That money was among more than $1.3 million MedStar hospitals received in the latter half of 2013, making them the top recipients in the region of drug company spending, according to a recently released Centers for Medicare and Medicaid Services database.

That Open Payments database made headlines late last month when it was released, showing $3.5 billion went to U.S. physicians and teaching hospitals from drug companies during the final five months of last year.

The amount spent in the region trails other areas of the country. For example, the Wall Street Journal reported a single unit in a Duarte, California, medical center received $122.5 million from Roche Holding as royalties on sales of drugs such as Herceptin and Avastin, which treat cancer.

Our look at the database shows the University of Maryland Medical System in Baltimore, meanwhile, received more than $324,000 in the last five months of 2013 from drug companies, and Fairfax-based Inova Health received more than $28,000.

The database has gotten a lot of attention — and is worthy of scrutiny, experts say — because drug company spending has a big influence on the care patients receive, even if health care providers don’t realize it. While much of the focus has been on the money doctors receive directly from drug companies, less has been said about hospital relationships and how the money might ultimately influence doctors.

Columbia, Maryland-based MedStar Health said the large educational grants were provided for accredited, continuing medical education at the Cardiovascular Research Technology 2014 Conference held in February, MedStar Health officials said in a statement. The conference attracted 1,700 medical professionals from across the globe to learn about complex interventions and the new technologies in treating cardiovascular disease.

“The Hospital Center is nationally accredited as a sponsor of CME by the Accreditation Council for Continuing Medical Education and follows all regulatory rules and protocols for receiving educational grants to support CME programs,” MedStar Health said in the statement. “The appropriate documentation of the grants and disclosures were made as part of the CME process.

One of the sponsors, Chicago-based Abbott Laboratories, said it has long supported programs that increase scientific, clinical and health care issues that impact patient care: “We want to do our part to ensure that patients, and the health care providers who treat them, receive the information and support they need.”

John Murphy, the assistant general counsel for the Pharmaceutical Research and Manufacturers of America in Washington, acknowledged concerns about relationships between drug companies and health providers, but said those relationships are also a crucial part of how research moves forward and how doctors learn about new treatments.

“The numbers show this research and development is not solely performed in house at pharmaceutical companies. It’s created through collaboration,” he said.

Those relationships with teaching hospitals, however, aren’t so innocuous — even when, as in the case of MedStar Health, they are simply funding education not tied to a specific drug or device, said Dr. Adriane Fugh-Berman, who studies these relationships.

Companies begin promoting a new drug at least seven to 10 years before it ever comes to market, she said. They often do this by promoting what are called “disease states,” or conditions that aren’t recognized as diseases. They begin educational outreach and hire key leaders in the medical community to inform doctors about these conditions, said Fugh-Berman, an associate professor in the department of pharmacology and physiology at Georgetown University and the department of family medicine at Medstar’s Georgetown University Hospital.

Sometimes it’s done through conferences, she said. Other times it’s through grand rounds, which are regular information sessions that are part of ongoing clinical education for medical residents, students and attending physicians.

“The way it works is, a company might say they are going to fund grand rounds for a year,” Fugh-Berman said. “They might offer a ‘suggested’ list of speakers. Just suggested. But there is this unspoken agreement. If they can get two or three of what are called ‘message talks’ into the lineup along with the unbiased talks, they’ll keep funding the program. The organizers know this.”

Fugh-Berman is a self-described critic of pharmaceutical company funding for education who was once asked to speak for a hospital’s grand r ounds. That hospital promptly lost its funding, she said — an example of what happens when medical education organizers don’t appease their funding source, even if there are no outright strings attached. She said she understands taking funding from the industry to a point when it comes to research, but not when it comes to education.

“It ends up distorting the medical information that’s out there,” Fugh-Berman said. “Doctors don’t realize how restricted the information stream is. The industry controls medical information.”

MedStar Health said it works to closely track potential conflicts and oversee ethical behavior among its associates. The health system’s relationships with industry has important benefits. “MedStar makes patient welfare its first priority and strives to assure that all relationships with industry meet the highest standards of professional ethics,” they said.

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