Monday, July 6, 2015

Consulting deals with medical companies can earn doctors six-figure paydays

For the past five years, Coon Rapids cardiologist Dr. Jeffrey Chambers has led a nationwide study that found doctors could safely use a Minnesota-made medical device to drill out hardened calcium in clogged arteries around the heart.


A report of the study’s results published last year disclosed that Chambers was a paid consultant.


Federal data published last week reveal the extent of those payments — $296,000 in 2014 from New Brighton-based Cardiovascular Systems, Inc. It was among the highest such totals in the state.


Cardiovascular Systems says Chambers’ expertise is a vital asset for a study investigating the safety of its product, and that the amount of its payments are typical for the industry.


Critics ranging from bioethicists to consumer groups say such payments create a risk of bias in clinical studies. It’s a long-running debate in Minnesota’s health care community, and one of the key questions emerging from the federal data published last week disclosing $6.5 billion in drug and device-company payments to 600,000 doctors in 2014.


Manufacturers have a huge financial stake in the outcomes of clinical studies because positive results are crucial to getting regulatory approval to sell their products. Organizations like the Mayo Clinic and the University of Minnesota no longer allow their doctors to serve as investigators on studies if they have consulting deals with makers of the devices or drugs being tested.


“When a Mayo employee is doing consulting for a company, it is Mayo Clinic policy that is inappropriate for them to do research on the company’s products,” said Mayo radiologist and industry-relations expert Dr. Richard Ehman, describing the health system’s policy on financial relationships with industry.


Proponents argue doctors shouldn’t have to work for free to advance state-of-the-art science. And close collaboration with industry is essential to inventing new technology like the Diamondback 360 Coronary Orbital Atherectomy System that has been on the market since October 2013 and that Chambers and his trial team have studied since March 2010.


“We believe the involvement of physicians in clinical trials for new medical devices and applications is critical,” Cardiovascular Systems spokesman Jack Nielsen said in an e-mail to the Star Tribune. “As a leading interventional cardiologist, Dr. Chambers’ expertise is vital when investigating the safety and efficacy of new medical technology products.”


Nielsen noted the company has rigid rules for conducting the study involving 443 patients at 49 health care centers. The company paid Chambers for serving as principal investigator of the study, and for presenting data at scientific and federal policy meetings, as well as training other doctors to use the Diamondback 360 device.


Chambers, who works at Metropolitan Heart and Vascular Institute, didn’t return calls for comment about the payments.
 

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