AMA takes on generics and CME

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The American Medical Association's House of Delegates voted to take on the drug industry's practice of "pay-for-delay" deals in which branded drug makers pay generics companies to hold off on flooding the market with cheaper generic versions of their medications. The vote was one of many which included an endorsement of Medicare coverage for the Tetanus, Diphtheria and Pertussis vaccine and a stand against allowing pharmacists to administer vaccines without being bound by a physician's direction.

Targeting generics makes sense from both sides – a 2012 report by the Generics Pharmaceutical Association states that generics were responsible for $192.8 billion in lower healthcare costs in 2011. At the same time, the patent cliff has deprived the industry of the blockbuster highs that nascent pipelines have yet to replace. This past quarter Pfizer's Lipitor sales tanked 71%, to $749 million. Just one year before, that same statin brought in $2.6 billion for the third quarter alone. Bristol Myers-Squibb, along with other industry peers, experienced a similar generics-triggered fall off and saw Q3 Plavix sales dive 96.4% compared to the year before, to $64 million. The blood-thinner went generic in May.

The fight over pay-for-delay has been kicked around Congress, the Federal Trade Commission and the Supreme Court. A quick look at the lobbying numbers shows why: Pfizer, Amgen and Abbott were among the top five political contributors in the Pharmaceutical/Health Products industry between 2011 and 2012, according to the Washington-based research group Center for Responsive Politics. The top three donors among the pharmaceutical manufacturing set were Pfizer, which contributed $1.5 million, Amgen, at $1.2 million, Abbott, $1 million.

The AMA also has financial heft, having funneled $9.2 million towards lobbying efforts so far this year, and providing $21.5 million in lobbying cash the year before, according to the Center for Responsive Politics.

The association's delegates also voted in constitutional and bylaw changes to insulate physicians from outside pressure. Among the changes to its Principles for Physician Employment was wording that said the AMA should ensure autonomy “in clinical decision-making and self-governance” and promote physician leadership in health organizations. Changes also included incorporating changes that were hammered out in 2011, such as just where the association stands when it comes to continuing medical education financial incentives. The amended recommendation is that physicians “decline any subsidy offered by a commercial entity other than the physician's employer to compensate the physician for time spent or expenses of participating in a CME activity.”
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