As some of you will recall, last week I wrote about the ongoing, cyclic nature of medical device-maker kickback schemes. First, it seems, the manufacturers do, indeed, pay kickbacks to physicians--then they get caught. They pay a settlement, apologize, and over time, go right back to doing it again. I'd suggested a few ways to break the cycle, including huge increases in penalties for violations and bans on selling products in the U.S. for companies convicted of kickback schemes.
This topic seemed to touch a nerve. After the editorial appeared, several of you shared some thoughts on slowing the gravy train, including the following:
"I doubt raising the fines will do anything other than increase the cost of business for such players in the device field. They would just pass on the costs to the customers (patients and third party payers). However, banning the manufacturer from selling his product(s) for six months or a year to anyone or any institution that directly or indirectly receives federal dollars should work. The cost of business would now be very high: no revenue for a long period of time. That should be enough to attract the attention of the corporate bean counters and investors." -- Healthcare consultant
"Why not publish the names of doctors who have accepted kickbacks from the device makers? Make it available publicly to all who rely on that doctor. Maybe insurance companies will not want to deal with them because they drive up costs. Maybe patients will not want to go to them because they are crooked. Maybe their colleagues will look down on them for taking kickbacks. Cause the doctors some embarrassment. Perhaps a little transparency there could go a long way to reducing the problem." -- Health IT professional
But then, I also heard from a reader who pointed out that all financial incentives aren't equal:
"As a sales rep for a medical company I will offer that bringing new products through the testing, development, and regulatory phase is not easy and often requires the participation of physicians and other healthcare providers to assure that the product delivers the best possible results for the patients. Physicians will not break from normal routine to assist in these evaluations without some type of incentive to do so. I think regulating on this type of incentive should be held to a different standard than post-market-release incentivizing."
Obviously, the issue of device-maker relationships with doctors is complex--but ultimately, at its core, the question is what we can do to provide manufacturers and doctors with different incentives. As long as pay-for-play makes financial sense (and nobody has a better approach for helping device-makers reach their sales goals) it's never going to go away. - Anne