Ethics code proposed to guide physician, for-profit health sector interactions

The Council of Medical Specialty Societies released a code for medical specialty societies, their members and publications to voluntarily follow regarding appropriate interactions with for-profit companies in the health care sector.

The Council of Medical Specialty Societies (CMSS) said its “Code for Interactions with Companies” is designed to ensure that relationships with companies are independent and transparent, and advance medical care for the benefit of patient care populations.

The code, as published on the CMSS Web site, is more stringent than the Physician Payment Sunshine Act which was incorporated into the Patient Protection and Affordable Care Act (PPACA), commonly known as the health care reform act, which was signed into law by President Obama last month.

Core principles

According to the CMSS, the code includes core principles and detailed guidance on implementation. The principles included in the code and guidance suggestions for each are:

Conflicts of interest: Develop and publicly post policies and procedures to disclose and manage conflicts of interest among those who participate in society activities — medical meetings, clinical practice guidelines, scientific journals;
Financial disclosure: Publicly disclose donations and support received from for-profit companies in the health sector, and disclose board members’ financial and uncompensated relationships with companies;
Independent program development: Develop and make publicly available policies and procedures that ensure that educational programs, advocacy positions, and research grants are developed independent of industry supporters; and
Independent leadership: Prohibit society leaders (presidents, CEOs, and editors-in-chief of society journals) from having direct financial relationships with relevant for-profit companies in the health care sector.

According to a CMSS press release, it represents 32 medical professional societies with a collective membership of more than 650,000 U.S. physicians.

“Physicians and patients count on medical societies to be authoritative, independent voices in science and medicine,” Allen Lichter, MD, chief executive officer of the American Society of Clinical Oncology, and chair of the CMSS Task Force on Professionalism and Conflict of Interest, stated in the press release. “By adopting this code, societies demonstrate their commitment to the highest level of ethical standards in their activities and to providing the best possible care for patients and populations.”

Physician Payment Sunshine Act

The Physician Payments Sunshine Act of 2009, originally introduced by Sens. Charles Grassley (R-Iowa) and Herb Kohl (D-Wisc.) put the onus of disclosure on industry, requiring device and biologic makers to report payments to doctors to the Department of Health and Human Services. That bill was not passed independently, but included as a provision of the PPACA and is scheduled to go into effect in March 2013.

“Shedding light on industry payments to physicians would be good for the system,” Grassley said when introducing the bill to the Senate. “Transparency fosters accountability, and the public has a right to know about financial relationships.”

Under the Sunshine Act, manufacturers must disclose any “in kind” payments made to physicians or teaching hospitals in the form of compensation; food, entertainment or gifts; travel; consulting fees; honoraria; research funding or grants; education or conference funding; stocks or stock options; ownership or investment interest; royalties or licenses; charitable contributions; and any other transfer of value as described by the secretary of the Department of Health and Human Services.

“Appropriate” relationships

As of press time, 13 medical societies have adopted the CMSS code, including the American Academy of Family Physicians, the American Academy of Pediatrics and the Accreditation Council for Continuing Medical Education. The full code and the list of signers who have adopted it thus far are available on the CMSS Web site.

“The private sector plays a central role in developing new treatments and medical advances, and medical societies collaborate with industry in many ways that benefit medical practice,” Norman Kahn, MD, executive vice president and chief executive officer of CMSS, stated in the release. “We developed this code to ensure that those relationships are appropriate, and to ensure public confidence in our objectivity and commitment to high-quality care.”

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