A new themed issue of JAMA delves into the complicated relationships and practices that can result in conflicts of interest for physicians, medical journals, schools, and other healthcare entities.
A new themed issue of JAMA delves into the complicated relationships and practices that can result in conflicts of interest (COIs) for physicians, medical journals, schools, and other healthcare entities.
The issue, which includes 23 viewpoint articles, 3 editorials, and 2 original investigations, is outlined and summarized in one of the editorials, aptly titled “The Complex and Multi-Faceted Aspects of Conflicts of Interest.” Author William Stead, MD, explains that the vast majority of medical professionals want to do the right thing, but the many roles they take on within the healthcare system (eg, clinicians, educators, researchers, policy makers, or advocates) make them subject to a wide array of relationships that can lead to COIs.
One of the original investigations garnering the most attention was the one that examined the relationship between physician prescribing and policies regulating pharmaceutical sales visits, called “detailing.” The researchers found that 8 of the 11 academic medical centers that prohibited salesperson visits and gifts to their clinicians saw a significant reduction in prescribing rates of the detailed drugs, while just 1 of the 8 medical centers that did not enact such restrictions observed a change in prescribing.
Another study making headlines found that nearly half of all physicians in the United States accepted payments from the biomedical and pharmaceutical industries in 2015, for a total payout of $2.4 billion. The researchers found that surgeons were more likely to receive payments and had a higher average payment value than primary care doctors, and that men in each specialty were more likely than women to receive both general and license or royalty payments.
One viewpoint looked at COIs in a larger context, as it discussed the potential for institution-wide conflicts in schools of public health when they accept outside funding. The authors recommended increasing transparency and instituting a robust mechanism of unbiased experts to review the appropriateness of funding.
Some of the other topics discussed in the issue were:
Overall, the viewpoints, editorials, and research articles in the issue emphasize how important it is for the medical field to preserve its integrity and trustworthiness by minimizing or avoiding COIs and potential bias. Specifically, Stead’s editorial noted that the viewpoints “suggest a systematic approach in which all stakeholders in the health professions and biomedical sciences work together to protect professional judgment and integrity while advancing progress.”
Among these stakeholders are medical professionals, who “should think critically about conscious and unconscious biases affecting their judgment and the limitations of information resources,” and researchers, who can “advance measurement of bias and incorporation of information about COIs and bias into context-relevant decision aids for physicians and patients.”
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Homelessness Compounds Hospital Stay Challenges: Study Reveals Prolonged Discharge Struggles
March 28th 2024In this investigation, outcomes of interest were morbidity rate and length of hospital stay or a traumatic injury among a homeless population, and whether age and/or injury severity had an influence on that relationship—with implications for improving the discharge process for these patients.
Read More
FDA Approves Vadadustat for Anemia in Patients With CKD Undergoing Dialysis
March 28th 2024The FDA approved vadadustat (Vafseo), an oral medication, to treat anemia in adult patients with chronic kidney disease (CKD) on dialysis for at least 3 months. This fills a need for a new treatment option as anemia is common in these patients and can significantly impact their quality of life.
Read More