Four makers of artificial hips and knees paid doctors more than $800 million in royalties and fees in four years to influence their choice of implants, a U.S. investigator told Congress.
The unidentified companies control about three-quarters of the $9.4 billion worldwide market for hips and knees, said Gregory E. Demske, an assistant inspector general at the Health and Human Services Department, at a hearing yesterday of the Senate Special Committee on Aging.
"Illegitimate" payments, the extent of which is unknown, influence orthopedic surgeons' medical judgment and are so common that it will be difficult to eliminate the practice, Demske and other witnesses said. The fees have enriched doctors and distorted the market by bolstering sales of lower-quality devices, they said.
"Industry and physicians are equally culpable," said Sen. Herb Kohl (D-Wis.), chairman of the panel. "Some physicians make it known to the companies that they will be loyal to the highest bidder. Where does the patient's well-being fit into the equation?"
The hearing followed a probe of the orthopedic-device industry by U.S. prosecutors that was settled in September for $311 million. The government said the companies handed out excessive consulting agreements, lavish trips and other perks to reward surgeons who used their products. ...
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