Medicaid Panel Members Required To Disclose Ties To Pharmaceutical Companies

A Minnesota law that requires pharmaceutical companies to reportcertain payments to physicians is "shining a rare light onto the bigmoney" spent on Medicaid drug formulary panel members, the AP/Philadelphia Inquirerreports. The state is one of three in the U.S. that requires drugmakers to disclose payments made to physicians for lectures, consultingand other services, along with Maine and Vermont.

The MinnesotaMedicaid Drug Formulary Committee earlier this year began consideringconflict-of-interest rules that would require panel members to disclosefinancial relationships with drug companies and recuse themselves fromvoting in some cases. The committee next month is expected to act onthe rules.

A review of state records conducted in mid-June by the Associated Pressfound that a physician and a pharmacist on the eight-member panelreceived simultaneous payments -- one for more than $350,000 -- fromdrug makers for services. Both of the members and the committee chairsay the payments did not influence their work on the committee.

However, the AP/Inquirerreports that it is "difficult to track any link between payment andpolicy" because members' votes are not recorded. State officials saidthey would review the panel's past actions to see whether paymentsinfluenced members and they would start screening appointees to twodozen advisory panels for potential conflicts of interest. In addition,the state will require the Drug Formulary Committee to begin recordinghow panel members vote.

Ethics

Ethical experts say the findings raise questions about conflicts in other states. Jack Hoadley, a research professor at Georgetown Universitywho specializes in Medicaid, said, "In the absence of disclosure laws,there's certainly no way to know," adding, "There are a lot ofphysicians in general who have at least some contract or grant fundingout of pharmaceutical companies."

Arthur Caplan, chair of medical ethics at the University of Pennsylvania School of Medicine,said, "This is a high-stakes committee. If you're going to have yourhand on that tiller, you don't want to think that anybody is trying topush it" (Lohn, AP/Philadelphia Inquirer, 8/22).

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