“Tens of thousands of U.S. physicians are paid to spread the word about pharma’s favored pills and to advise the companies about research and marketing,” reports a new investigation from ProPublica, an independent, nonprofit newsroom for investigative journalism. Consumer Reports, along with NPR, PBS Nightly Business Report, Boston Globe, and the Chicago Tribune, have joined with ProPublica to help inform the public about its report on these financial arrangements.
ProPublica has identified more than 17,000 health-care providers (mostly doctors) who have accepted payments from pharmaceutical companies dating back to 2009; 384 collected more than $100,000 in 2009 and 2010 (aside from doctors, they included a handful of pharmacists, nurse practitioners, and dietitians). Forty-three (all physicians) made more than $200,000, and two doctors grossed over $300,000.
ProPublica’s comprehensive database, available to the public, lists the doctors on pharma payrolls that were disclosed by seven drug companies: AstraZeneca, Cephalon, GlaxoSmithKline, Johnson & Johnson, Lilly, Merck, and Pfizer. Some of the companies were forced to disclose this information as a result of legal settlements; others released it voluntarily.
The payments are not illegal, and indeed ProPublica notes that strong relationships between pharmaceuticals and physicians can be beneficial and lead to more advanced treatments. But studies have shown that even small gifts and payments to doctors may affect physician attitudes. A separate Consumer Reports poll conducted to coincide with the publication of the investigation found that 74 percent of Americans disapprove of doctors taking payments from drug companies in exchange for promoting specific drugs to other doctors.
The actual number of physicians who receive such payments could be much higher than the number documented in the investigation. More than 70 pharmaceutical companies have not disclosed payments made to physicians, although that information will be public in a few years: By 2013, pharmaceutical companies will be required by the new health-reform law to disclose such payments to the federal government, which will post it online.
“Consumer Reports Health has been concerned about drug companies’ financial relationship with doctors for some time. This investigation begins to pull back the shroud on these activities,” says John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center. “The amount of money involved is astounding, and the ProPublica report’s account of the background of some of the physicians is disturbing.”
Drug companies told ProPublica that the payments are used to hire the most respected doctors in their fields to educate other doctors about the benefits and risks of drugs. But ProPublica said it reviewed disciplinary records and found sanctions-–some as serious as inappropriately prescribing drugs or having sex with patients-–against more than 250 of the paid speakers. Another 40 have received warnings from the FDA for research misconduct, lost hospital privileges, or were convicted of crimes, the report said, and at least 20 had two or more malpractice judgments or settlements.
Another report from the ongoing investigation examined disclosures from a series of lawsuits from whistleblowing former employees of pharmaceutical companies. In the past three years, says the report, drugmakers have paid nearly $7 billion in settlements; these include some cases that allege illegal marketing of drugs for off-label purposes, and rewarding top prescribers.
“Lets hope that this report and others that follow will convince American physicians that it is time to stop listening to pharmaceutical companies and focus on the people who are counting on them to have their medical and economic interests at heart-–their patients,” says Santa.
—Kevin McCarthy, associate editor
Read the full set of Propublica reports for complete details.