Orthopedic Surgeons' Buck-raking Exposed
Nearly 50 orthopedic surgeons, many affiliated with the nation's top teaching hospitals, each earned over $1 million a year in consulting contracts and royalties from the five companies that make artificial knees and hips. The payment disclosures were posted on the companies' websites last week as part of a $311 million anti-kickback settlement between four of the firms and the U.S. attorney for northern New Jersey. The complaint had accused the companies of using consulting contracts as an illegal kickback scheme to get surgeons to use a particular company's artificial joints.
The top two earners were Thomas Thornhill, chair of the orthopedics department at the Harvard-affiliated Brigham and Women's Hospital in Boston, and Robert Scott, also at Brigham and Women's, who each collected $6.7 million in the first ten months of 2007 from DuPuy Orthopaedics, a unit of Johnson & Johnson. In a statement released Friday, the two men claimed the money came from consulting fees and from patent royalties on an artificial knee licensed to J&J in 1986 and an artificial hip licensed to J&J in 1991. They said in a prepared statement that they collected no royalties on DuPuy products used at their hospital, and all the consulting fees were donated to charity.
Norman Scott of the Insall Scott Kelly Institute for Orthopaedics and Sports Medicine in Manhattan collected $5.5 million in payments so far in 2007 or about $25,000 a day from Zimmer Inc. The institute's website claims an affiliation with the Albert Einstein School of Medicine, but the Yeshiva University affiliate says Scott's appointment ended in 2005. A secretary at the institute refused to comment or put a call through to Scott. Richard H. Rothman of the Rothman Institute, the former chairman of the orthopedics department at the Thomas Jefferson Medical School in Philadelphia, received $2.4 million in 2007 or about $12,000 a day from Stryker, a division of Howmedica Osteonics Corp. A spokesman for the institute, contacted Sunday, refused to comment. A full list of the surgeons who collected more than $1 million in payments can be found here.
With seniors accounting for nearly 70 percent of the knee and hip replacement market, Medicare spent $16 billion on the procedures last year. A typical knee replacement costs $33,000, according to Medicare records. A spokesman for Christopher J. Christie, the U.S. attorney in Newark, said the investigation into the alleged kickback scheme is ongoing.
Gas Industry Flouts Clean Water Laws; BLM Dithers
Natural gas companies that use an underground extraction process pioneered by Halliburton Co. may be violating the nation's clean water laws, but the Bush administration refuses to exercise scientific oversight, Rep. Henry Waxman (D-CA) charged at a House Committee on Oversight and Government Reform hearing last week. The Bureau of Land Management has failed to complete a study of the environmental and health impacts of the process that was promised in 2005. The process, known as hydraulic fracturing, injects hydrocarbon waste fluids into underground coal beds. That forces natural gas to the surface, but leaves behind a toxic residue of benzene, toluene, mercury, and other waste products, which may migrate into underground water supplies.
The Energy Policy Act of 2005 exempted hydraulic fracturing from groundwater protections that would normally apply under the Safe Drinking Water Act and the Clean Water Act. But the law required the Interior Department to commission a National Academy of Sciences study of hydraulic fracturing. The study, due 14 months ago, hasn't been started. The agency chose a less expensive alternative, which the BLM itself concluded would be of "limited value," because the cost of conducting the more extensive review "would have an impact on BLM's ability to provide sufficient funding to process additional" oil and gas drilling applications, according to internal agency documents obtained by Waxmans oversight committee.
Shining Light on Physician Payola Gets Boost
A New England Journal of Medicine article assessing the prospects for the Physician Payments Sunshine Act, which would require that drug companies reveal all their payments to physicians, listed the consequences of the ubiquitous conflicts of interest that plague modern medicine. While granting that physician-industry interaction was important for clinical trial enrollment and occasionally educated physicians about drugs that are underused, the review emphasized the negative effects of the payments:
ExxonMobil Sullies Science on Polar Bear Decline
A recent study that claims polar bears are not harmed by global warming was funded by ExxonMobil, New Scientist reported. The study, which appears in the September 2007 issue of Ecological Complexity, claims that a human-caused role for warming Arctic temperatures "remains difficult to identify," and that predictions of polar bear decline are "highly premature." The study's authors include Willie Soon and Sallie Baliunas of the Harvard-Smithsonian Center for Astrophysics, both of whom are affiliated with the George C. Marshall Institute, which receives funding from ExxonMobil; David Legates of the University of Delaware Center for Climatic Research, who has received funding from ExxonMobil, the DaimlerChrysler Corporation, and the El Paso Energy Foundation; and Timothy Ball of the Natural Resources Stewardship Project in Calgary, which has ties to lobbyists for Canadian utility companies.
The article received no peer review and the journal Ecological Complexity has no disclosure policy for its authors. The article was cited by the State of Alaska in its filing with the Fish and Wildlife Service opposing endangered species protections for the polar bear. Brad Miller (D-NC) of the House Committee on Science and Technology last month demanded that ExxonMobil turn over all records of its support for polar bear research.
IOM Adds Two to Conflicts of Interest Panel
Responding to criticism that the panel investigating conflicts of interest in medicine lacked balance, the Institute of Medicine last week added two prominent researchers to its roster. Lisa Bero of the University of California at San Francisco and Eric Campbell of Massachusetts General Hospital, both of whom have documented the extent and impact of financial conflicts of interest in medicine, join the now 17-member committee. The panel includes three members granted conflict-of-interest waivers because of their ongoing ties to drug and medical device companies, and at least one other with recent ties to industry that were neither waived nor revealed on the IOM website. The committee holds its first meeting today and Tuesday.
Odds and Ends
The Food and Drug Administration proposes posting the entire roster of an advisory committee meeting on the day that it releases briefing materials for the meeting, which is usually a day or two early, according to a draft guidance . . . . Michigan Democrats introduced legislation last week that would limit drug company gifts to doctors to $100 a year. The legislation makes Michigan the first state to consider limiting the practice; Minnesota and Vermont require disclosure of all physician gifts. The bill isn't expected to go far since the state Senate is controlled by Republicans . . . . Consumers International issued a new report "Drugs, Doctors and Dinners" that claims multinational drug companies showering gifts on doctors in the developing world leads to half of all drugs sold there being wrongly prescribed, the London Independent reports. The report calls for banning the practice . . . . Office of Science and Technology Policy director John Marburger, President Bush's chief science adviser, was responsible for severely editing CDC Director Julie Gerberding's testimony on climate change and health impacts, Naturenews reports (subscription required) . . . . the United States Department of Agriculture's Wildlife Services agency, which according to its website implements "sound, science-based projects designed to reduce conflicts between humans and wildlife," last year spent $108 million to kill 1.6 million animals. A record number of those killed were protected under the federal Endangered Species Act, according to agency statistics compiled by Sinapu and Public Employees for Environmental Responsibility . . . . The revolving door keeps spinning: Robert E. Brackett, director of the FDA's food safety division, will join the Grocery Manufacturers Association, which represents food, beverage and consumer-products companies, the Washington Post reports. His predecessor, Joseph Levitt, moved to Hogan and Hartson, a lobbying firm whose clients include numerous food firms.
Cheers and Jeers