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Arizona Governor Issues Executive Order Following NPR Investigation


For years the pharmaceutical industry has worked to influence how money is spent by state Medicaid programs. That came to light last month in our investigation of the committees that determine which drugs states cover with Medicaid. We found out that 3 out of 5 doctors who serve on those panels receive payments from drug companies. Arizona's governor was listening, and he's now changing the setup in his state. NPR's Alison Kodjak reports.

ALISON KODJAK, BYLINE: Arizona Governor Doug Ducey says NPR's joint investigation with the Center for Public Integrity opened his eyes to the potential conflicts of interest on his state's Medicaid drug committee.

DOUG DUCEY: When we learned that a member of Arizona's Pharmacy & Therapeutics Committee had received compensation - as much as $700,000 from drug companies - it allowed us to ask questions.

KODJAK: According to our investigation, that doctor, Mohamed Ramadan, got more compensation from pharmaceutical companies than any other doctor serving on a Medicaid drug committee across the U.S. The committees are instrumental in determining which prescription drugs get preferred treatment by state Medicaid programs, which can mean lots of revenue for their manufacturers. The revelation spurred Ducey to action.

DUCEY: We came to the decision of making a clear choice here of someone who's receiving this amount of compensation has a conflict of interest. So we thought removing the board member was the best course of action.

KODJAK: Ramadan didn't respond to several calls and emails from NPR and the Center for Public Integrity. And Ducey didn't stop with one doctor. Last week, he also issued an executive order requiring all committee members to receive conflict of interest training and to abstain from voting or even discussing medications if they have a financial relationship with the manufacturer. The order also requires people who speak at committee hearings to disclose any ties they have to drug companies.

DUCEY: And we just believe that decisions about health care should be made in the best interests of Arizonans without the appearance of undue influence.

KODJAK: Liz Whyte, the reporter who led the investigation at the Center for Public Integrity, says Arizona is not alone.

LIZ WHYTE: There are at least 38 states that have doctors on their Medicaid drug committees who've gotten more than $1,000 from pharma companies during the 4 1/2-year period that we looked at.

KODJAK: And the follow-up from our investigation wasn't limited to Arizona. Here's Liz Whyte again.

WHYTE: A doctor on the New York drug Medicaid committee resigned because he didn't disclose accurately his ties to drugmakers. And an official in New York divested his stock of pharmaceutical companies due to a potential perceived conflict of interest.

KODJAK: Walid Gellad says financial conflicts of interest are a fact of life in medicine.

WALID GELLAD: There are conflicts with drug companies. There are conflicts with insurers. There are conflicts with hospitals, pharmacies. There are conflicts everywhere.

KODJAK: Gellad runs the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh. He says disclosing financial ties should be standard practice, especially for people serving on decision-making boards.

GELLAD: At least they can be out on the open. If they're hidden, they can't be addressed.

KODJAK: And in Arizona at least those ties will be more transparent in the future. Alison Kodjak, NPR News. Transcript provided by NPR, Copyright NPR.

Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.