Do any of the Big Pharmas pay your doctors?

A huge transformation is on way that will gear up medical device and pharmaceutical companies to change the way they deal with the most important people involved in trials: Doctors. From early 2013 onwards, the federal government is expected to get a full report from these companies regarding every penny paid to physicians for consulting, speaking fees, research, meals and business travel. So how do you know if your doctor is on the pharma payroll? ProPublica, a nonprofit journalism organization, has created a new database that will provide a state-wise listing of which doctor has received how much payment from which pharma giant.

It is not surprising to know that physicians benefit from their association drug or medical device companies. Not to forget all the stationeries, stuffed toys, and branded stuff that would be scattered about at the doctor’s clinic! These little perks began to disappear from 2009 onwards when after the pharmaceutical industry voluntarily withdrew from these strategies in an effort to “try to counter the impression that gifts to doctors are intended to unduly influence medicine,” as reported in the New York times.

The newspaper further adds, “But some critics said the code did not go far enough to address the influence of drug marketing on the practice of medicine. The guidelines, for example, still permit drug makers to underwrite free lunches for doctors and their staffs or to sponsor dinners for doctors at restaurants, as long as the meals are accompanied by educational presentations.”

Well, the subject of much interest is now going to be these “educational presentations.”
According to ProPublica, “Eight pharmaceutical companies, including the nation’s three largest, doled out more than $220 million last year to promotional speakers for their products.” The drug and medical device companies inform the benefits of various products by creating slides in the presentations, which are presented to other doctors by those doctors hired and paid by the company.

This effort is said to fetch them the big bucks! In 2009 alone, a cancer specialist and speaker for a drug manufacturer Cephalon (CEPH), Nam Dan, pulled off nearly $131,250. In 2010, a Buffalo-based hematologist, Zale Bernstein cashed in $177,800 on the Cephalon circuit, apart from the additional $35,000 for travel. In the past 2 years, pain specialist, Gerald M. Sacks from Santa Monica earned $500,000 speaking and consulting gigs with four companies; and once again, it is all exclusive of travel and meal reimbursements.

In an email to ProPublica, Eli Lilly spokesman J. Scott MacGregor writes, “We continue to believe in the benefits and value that educational programs led by physicians provide to patient care.”

However, there are people who are concerned that compensating doctors to promote healthcare products might be quite unethical and create conflicts as the patient’s health may take a back seat as compared with the doctor’s bank account.
The Hard Sell for the Wrong Drugs: Lead ProPublica reporter Tracy Weber stated, “A lot of brand name drugs are not only super-expensive, but also have more severe side effects than older drugs. So it’s important to ask if there is something safer or cheaper? Another drug I should be using? Or non-drug alternatives? Especially with devices. It’s good to know if your physician is speaking on behalf of the company that makes a hip implant or heart device. Are they prescribing it based more on their relationship with the manufacturer rather than what’s best for you?”
Weber is taken aback by the amount of money earned by doctors by just training and lecturing other doctors. She says, “When we started putting this together, we thought the highest paid, the top speakers, would be really brilliant physicians with lots of research in their specialty area. Many of the highest paid speakers had none of that, very little or no published research, no affiliation with academic centers. So their speakers are chosen for some other reason than their expertise.”
Certainly, there are valid reasons as to why a drug or medical device company would provide funding to the doctor. Physicians receive critical research dollars from these companies for lab space, staff, and other costs related to medicine. It’s very simple to come across a situation where you know that your physician is on a company payroll and be presumptuous about the worst possibility. According to Weber, most doctors “feel very strongly that they are providing a valuable education service by talking about drugs they believe in.”

For instance, doctors in rural areas have very little access to cutting-edge research. In such a situation, these speakers may come to the rescue to keep those doctors informed.

So what is the general public supposed to make of the ProPublica’s database, which enlists doctors and the payments received? It’s a pretty simple tool: Enter your doctor’s last name and state. If something shows up, see how the compensation is classified. If you are comfortable with the details, that’s good! If you are uncertain about how you feel, walk up to your doctor and talk about it.

To conclude, Weber says: “If your doctor doesn’t want to talk to you about it, I think that’s something worth taking note of.”