Most Americans — 74 percent, according to a just-released Consumer Reports survey — don’t like the idea of their doctors taking payments from Big Pharma in exchange for promoting specific drugs to other doctors.
Yet thousands of U.S. doctors do just that — and often for huge sums of money, according to a new major “Dollars for Docs” investigation released today by ProPublica, a nonprofit, independent investigative reporting organization.
But the fact that so many doctors are on the payroll of drug companies is not the only problem. Although Big Pharma claims it hires the most respected doctors in the country to pitch its wares, ProPublic found that hundreds of the doctors on drug company payrolls have been accused of professional misconduct or were disciplined by their state boards.
“Their misconduct included inappropriately prescribing drugs, providing poor care or having sex with patients,” write lead reporters Charles Ornstein and Tracy Weber. “Some of the doctors even lost their licenses. More than 40 have received FDA warning for research misconduct, lost hospital privileges or been convicted of crimes. And at least 20 more have had two or more malpractice judgments or settlements.”
Even small gifts, payments can influence attitudes
Although many doctors claim that taking money from drug companies to speak about products doesn’t influence their prescription decisions, research has shown that even small gifts and payments can influence physician attitudes — and without them realizing it.
“The implications are great for patients, who in the past have been exposed to such heavily marketed drugs as the painkiller Bextra and the diabetes drug Avandia, which were billion-dollar blockbusters until dangerous side effects emerged,” write the ProPublica reporters.
There are many parts to the “Dollar for Docs” project, which was produced in collaboration with NPR, PBS’ Nightly Business Report, the Chicago Tribune, Boston Globe and Consumer Reports.One of the key features is a searchable database of about 17,700 U.S. doctors who received almost $258 million dollars from seven Big Pharma companies during 2009 and the first six months of 2010.
As ProPublica points out, these are the companies that have agreed to make such information public, either voluntarily or as the result of lawsuits. (These seven companies have about a 36 percent share of the pharmaceutical market. They took in about $109 billion in sales — that’s right, billion — in 2009.) Some 70 other drug companies have yet to release their data on payments to doctors. Furthermore, even the data from these seven companies is incomplete. For example, if a group of doctors rather than an individual doctor received payment, that payment wouldn’t appear in the database.
384 received more than $100,000
ProPublica includes a list of the 384 individuals in the database who received more than $100,000 from one or more of the seven drug companies in 2009 and 2010. A review of that list reveals five names from Minnesota, including two physicians at the University of Minnesota: family practitioner Dr. Joseph Keenan ($125,125 from GlaxoSmithKline) and internist and endocrinologist Dr. John Bantle ($104,028 from Eli Lilly and Merck). The other Minnesota doctors on the list are child psychiatrist Dr. Annette Smick ($128,416 from Eli Lilly, AstraZeneca and Pfizer), anesthesiologist Dr. Todd M. Hess ($169,754 from Pfizer, Eli Lilly and Johnson & Johnson), and Dr. Kenneth F. Tempero ($213,656 from Cephalon).
In total, 328 payments were made to Minnesota physicians in 2009-2010, for a total of $3,063.749.
Two years ago, the Pioneer Press conducted its own investigation of drug company payments to Minnesota physicians. At that time, it found that 20 doctors had received payments in excess of $100,000 in 2008. It would seem, therefore, that the flow of money to Minnesota doctors is on the wane.
Still considerable amounts
Yet although the amounts to individual physicians may be less, they’re still considerable. One of the doctors in the $100,000+ club mentioned in the Pioneer Press piece was Dr. Tracy Tomac, a Duluth psychiatrist who currently serves on the Minnesota Board of Practice, a licensing group for physicians. She doesn’t make ProPublica’s $100,000+ group, but she still brought in a considerable sum in 2009-2010 ($94,276 from Eli Lilly).
As part of the health-care reform law passed earlier this year, all drug companies will have to release data of payments to physicians by 2013. In the meantime, ProPublica invites you to type your doctor’s name into their database and see if he or she accepts money from a drug company. If there is a match — or even if there isn’t, because, remember, most payments aren’t in this database — bring up the issue with your doctor at your next appointment.
“It’s time for Americans and their doctors to have a frank talk about drugs,” writes Kevin McCarthy, associate editor for Consumer Reports. “… It’s a conversation worth having, and disclosure of these sometimes-secret relationships is a good reason for involved doctors to come clean.”