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Doctors on Pharma Payroll: What Our Partners Found

While it’s not illegal for doctors to promote prescription drugs and accept payments from drug companies, such arrangements do raise ethical questions that some institutions have found concerning enough to try to limit.

The doctors handpicked by pharmaceutical companies as promotional speakers or consultants are supposed to be the most respected in their fields, but that’s not always the case, according to an investigation we launched today.

Using data culled from the disclosures made by seven major pharmaceutical companies, we found hundreds of doctors on drug company payrolls “who had been accused of misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.”

But that was just our focus. The project itself was a partnership with five other news organizations, NPR, the Chicago Tribune, the Boston Globe, Consumer Reports, and PBS’ Nightly Business Report. We assembled the database—tens of thousands of records totaling $257.8 million in payments from pharmaceutical companies to more than 17,000 doctors—and our collaborators had license to dig away. Here’s some of what they found:

The Chicago Tribune took the data for Illinois and contacted more than two dozen Illinois doctors who took home the most in drug-company cash. While most of the doctors told the Tribune they simply enjoy teaching others about new medications and research, accounts varied when describing how much control drug companies try to exert over these sponsored events:

"I enjoy teaching. I don't do it for the money,” Dr. David McNeil, a psychiatrist, told the Tribune. “The companies are very explicit that they don't want shills, advertisements, infomercials. They want us to discuss the research and a little bit from our practice."

Contrast that with what another Illinois psychiatrist said:

“In the last five years, it's become distinctly less interesting to me. To be given a slide set and be told this is what you can and cannot say was not exactly drawing on my expertise,” Dr. David Levine told the Tribune. Levine, who received $73,750 from Eli Lilly last year, said he’s not currently doing any speaking.

Our partners at the Boston Globe took a closer look at Harvard Medical School, whose doctors and researchers have collected almost half of the $6 million in drug-company cash that went to Massachusetts doctors.

Though some Massachusetts hospitals and academic institutions already have rules in place to crack down on such payments—particularly related to speaking events—enforcement is spotty, the Globe reported:

One of those physicians, Dr. Amjad Almahameed, a cardiologist at Beth Israel Deaconess and a Harvard instructor, was reported to have earned the third most among Massachusetts doctors, taking in $125,600 from GlaxoSmithKline. Almahameed declined to comment. Hospital spokesman Jerry Berger acknowledged that the doctor “may have given talks that were not in compliance,’’ but that he resigned from speakers bureaus in August.

Dr. Thomas Moore, associate provost for the Boston University medical campus, said the school is still reviewing doctors’ speaking engagements. But, he said, at least one doctor who spoke about doctor-patient relationships for Merck made up her own slides, and even though the company reviewed them, the school determined she controlled the material.

Other institutions, like Tufts Medical Center, do not require that the doctors control the content of their talks, but require that they agree with the material presented, the Globe noted.

Consumer Reports conducted a poll asking what Americans think about doctors who receive money from drug companies.  Despite many doctors’ assurances that the payments don’t influence how they practice, it’s still a topic that concerns many consumers:

About half of Americans said they would be concerned about the quality of care or advice from a doctor who accepted as little as $500 from a drug company, and two-thirds said they’d be concerned if a doctor took $5,000 or less. Most respondents (75 percent) were concerned about doctors who accept $25,000 or less.

To find out more about your own doctor, check our searchable database, which culled from the disclosures made by seven companies: Eli Lilly, Cephalon, AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck, and Pfizer.

Our partners at NPR have a helpful graphic of when these companies began making these disclosures and why. As it stands, while these companies in the database had a combined 36 percent share of the U.S. prescription drug market in 2009, they’re only seven of the more than 70 companies operating in the country.

Today and tomorrow, Nightly Business Report will be broadcasting this story as well. Be sure to check it out.

 

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