Device-maker kickbacks: Ending the cycle?

In this newsletter, you'll see a story every week or two about some medical device manufacturer who's caught providing kickbacks or bribes for doctors who use its product. When they're caught, the device maker makes its mea culpas, pay its fines and goes right back to business--where, if history is any indication, they go right back to finding new ways to buy business.

The question is, what can regulators do to take the potential for corruption out of this system?  Obviously, device and drug-makers are always going to have close relationships with physicians, so the incentive is always there, but perhaps it's possible to raise the risk or lower the reward.

Maybe it's time to try one or more of the following:

• Dramatically raise the penalties for manufacturers trying this kind of hanky-panky, up to and including a halt on sales of the affected product for 12 months or more.
• In egregious cases, ban the device manufacturer from doing any form of business in the U.S. for a short stretch.
• Kick up fines to the point where it really, truly hurts. Yes, I know some kickback settlements are in the multiple hundreds of millions, and that ought to be a scary number. Still, device maker behavior suggests that this just isn't quite scary enough. So turn the pain meter up even higher.
• Expand whistle-blower programs and raise awareness. Maybe regulators can do more to make themselves accessible to not only device-maker employees, but also doctors who feel pressured to make these deals or lose, say, favorable terms on equipment.

I'm not a device manufacturing business expert, nor am I an attorney, so I may be way off base here. What do you think regulators, professional associations or other stakeholders can take to lower the corruption level in medical device marketing?  I'd love to hear your ideas [1]. -Anne [1]