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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Tuesday, November 6, 2007

Two Brigham surgeons top list of device maker payments

By Elizabeth Cooney, Globe Correspondent

Two Boston orthopedic surgeons each received $6.75 million this year from a maker of joint replacement implants, the largest among hundreds of payments revealed in a $311 million settlement of a federal criminal case that alleged five companies paid doctors to use their products.

Dr. Richard Scott and Dr. Thomas Thornhill of Brigham and Women's Hospital were paid royalties and consulting fees this year by the Johnson & Johnson subsidiary DePuy Orthopaedics, according to documents made public by the company last week. DePuy makes implants used in hip and knee replacements.

Four other companies -- Zimmer Inc., Biomet Orthopedics Inc., Smith & Nephew Inc. and Stryker Orthopaedics -- were also part of an agreement with the US Department of Justice. The five companies, which together share 95 percent of the market for hip and knee implants, were being investigated for using consulting agreements with orthopedic surgeons to influence their choice of implants. Making payments was a common practice from 2002 through 2006, according to the US Attorney's Office in New Jersey.

The disclosures come as payments to doctors by device and drug companies come under increasing scrutiny because of concerns they create a financial conflict for physicians. But the industry, and many doctors and hospitals, defend the practice, saying it fosters innovation and properly rewards physicians for helping to develop new treatments.

Without admitting fault, the device companies agreed to make public their lists of payments for this year. Michael Drewniak, a spokesman for the US Attorney's Office, said in an interview yesterday that this year's payments were similar to amounts in previous years his office examined. More than 40 surgeons were paid $1 million or more this year, the lists showed.

Scott and Thornhill said in a statement supplied by Brigham and Women's that the royalties come from their design of a knee replacement implant licensed to J&J in 1986 and a hip replacement implant licensed in 1991. They said they donate their fees from consulting to charity.

"We are both very proud of the work we have done over the years to advance the mission of orthopedic medicine," their statement said.

Scott and Thornhill do not receive royalties when they or any other surgeons use their implants at the Brigham, they said. They did not break down the amounts of royalties and fees, nor were they available to comment beyond their statement.

DePuy, which will pay a fine of $84.7 million, issued a statement last week saying, "The surgeons who received the most significant compensation from DePuy Orthopaedics contributed intellectual property and ongoing expertise to the development of products."

Zimmer listed 15 Massachusetts General Hospital surgeons who received payments totaling $8.7 million this year. The hospital said in a statement that the money represents royalties for developing materials in the 1990s that are used in implants, and that the money goes to the hospital. Mass. General does not get royalties for implants that its surgeons use at the hospital.

"Ongoing research in orthopaedic surgery has led to enhancements in strength and durability of the materials, and the MGH continues to work with industry, including Zimmer and Biomet, to license and patent innovations that will benefit patients now and in the future," the hospital statement said.

Criminal complaints were filed against four of the five implant makers, charging them with conspiring to violate the federal anti-kickback statute, the US Attorney's office said, but the complaints will be dismissed if the companies comply with terms that include federal monitoring for 18 months and five-year corporate integrity agreements. Stryker cooperated with the investigation before the other companies and has entered a non-prosecution agreement with the government.

Zimmer will pay a fine of $169.5 million, Smith & Nephew will pay $28.9 million, and Biomet will pay $26.9 million.

Posted by Elizabeth Cooney at 06:18 PM
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