Uneasy alliance: clinical investigators and the pharmaceutical industry

Article Abstract:

The rise of for-profit contract-research organizations (CROs) and site-management organizations (SMOs) has commercialized medical research even more than normal. These organizations contract with the pharmaceutical and medical device industries to conduct large-scale research on their behalf. This shifts corporate sponsorship away from academic research, which is seen by industry as slow and expensive. Many clinical trials of drugs have always been funded by industry but the principal investigators still maintained a degree of independence. This will no longer be the case as CROs and SMOs must please their corporate sponsors or they will lose valuable industry contracts.

Research, Pharmaceutical industry, Finance, Medical research

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Disease management -- promises and pitfalls

Article Abstract:

It may be most appropriate to incorporate disease management into the traditional primary care practice. Disease management is the term used for the comprehensive services provided to people with chronic diseases such as diabetes. Some managed care plans 'carve out' this service by contracting with a separate disease management company. Some of these companies are run by drug companies whose obvious aim is to sell more drugs. Many focus on reducing costs by targeting high-risk patients and ignoring low-risk patients. Other managed care plans have created successful in-house disease management programs.

Management, Chronic diseases

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California's beleaguered physician groups -- will they survive?

Article Abstract:

Many physician groups in California may go out of business. In California, most managed care companies contract not with individual doctors but with groups of doctors. The HMO then delegates many responsibilities as well as risks to the group. When several HMOs pulled out of California, they left many physician groups with unpaid bills. Even HMOs that still operate are paying physician groups less to manage the same patients. The sickest patients are the most expensive, but these are the patients who need medical care the most.

Economic aspects, California, Managed care plans (Medical care), Group medical practice

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