Money and Medicine: Lucrative Relationships Not Always Disclosed

Sept. 14, 2010— -- It may not be obvious which study authors are being paid by medical device makers -- especially when the authors earn $1 million or more as consultants, according to new research.

Just 46 percent of the journal articles authored by highly-paid researchers disclosed their financial relationships with the orthopedic device industry, David J. Rothman of Columbia University and colleagues reported in the Archives of Internal Medicine.

Rothman's group examined information on payments by five orthopedic device companies to physicians in 2007 and compared financial disclosures in the recipients' journal articles. Of the 41 individuals who got more than $1 million that year, 32 had published articles relating to orthopedics between January 1, 2008, and January 15, 2009.

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These results show current disclosure policies by both journals and researchers are inadequate, Rothman told MedPage Today. That's troubling, he said, because the articles become part of the permanent scientific record used by practicing physicians, guideline committees, and patients to evaluate treatment options.

"This is a clear conflict of interest that [readers] would want to know about," Rothman said in an interview. "It doesn't mean it shouldn't be published … but readers should know that you have a real stake in this game."

Disclosure policies currently vary across journals, and they often lack specificity.

But there have been movements toward greater disclosure of payments to doctors from drug and device makers, with 15 companies now doing so on their websites.

Disclosure is expected to become even more widespread, with the enactment in 2013 of part of healthcare reform that requires industry to report all payments to physicians that are greater than $10 in a national, searchable database.

"We're entering a new game of public disclosure of income," said Rothman, who warns his medical students that their future earnings from industry will be public information.