Fast on the heels of a study published in the Archives of Internal Medicine this week showing that over 50% of cardiologists who write clinical practice guidelines have potential conflicts of interests with drug or device companies, comes an even more startling revelation. A new study published today reveals that an astounding 100% of those who write Medicare (CMS) guidelines have significant conflicts of interest. According to the study’s lead author, it appears that Medicare not only publishes guidelines about who should and should not get medical devices such as implantable cardioverter defibrillators (ICDs), but also Medicare is in the business of paying out money for these same devices. “It’s amazing,” states one of the study’s authors, “that for all these years no one noticed that the people paying out the money were also deciding who would get devices. This could certainly have an influence on these guidelines, potentially denying patients from getting life-saving devices in order to save money. It seems like an obvious conflict of interest in retrospect.” The study points out that private insurance companies seem to do no better than the government with respect to conflict of interest. “We were disappointed to find that private health insurance companies may also adjust their guidelines not based on medical science but based on the cost of paying for devices and other life-saving therapies,” stated another study author. “Sadly these companies which we naturally assumed only had the patient’s best interests at heart also were found to have a 100% conflict of interest rate.”
What to do with these conflicts of interest? “We may need to go back to using the guidelines written by physicians. At least only about 50% of these writers have a potential conflict of interest, compared to 100% of writers of Medicare and insurance guidelines,” concluded one author.