Consumers wary of doctors who take drug-company dollars

Consumer Reports News: October 19, 2010 12:10 AM

Would you trust a doctor who moonlights for a drug company? Most Americans are skeptical of such financial arrangements, according to a new, nationally representative poll of 1,250 U.S. adults from Consumer Reports National Research Center.

Most respondents, 74 percent, disapprove of doctors taking payments from drug companies in exchange for promoting specific drugs to other doctors. And 77 percent would be concerned-–some “very concerned” (37 percent) and others “somewhat concerned” (40 percent)-–about the quality of treatment or advice from a doctor who accepts such payments. Most think doctors should tell patients about the payments they’ve received from a company whose drugs they are about to prescribe.

We asked these questions because thousands of U.S. doctors are on drug company payrolls for activities such as giving speeches to other doctors about drugs, according to an analysis of publicly disclosed payments from seven pharmaceutical companies done by ProPublica, a nonprofit, independent investigative reporting organization. ProPublica also found that 384 health-care providers (mostly doctors, along with a handful of pharmacists, nurse practitioners, and dietitians) accepted more than $100,000 in payments from drug companies in 2009 and 2010. Our poll found that even modest payments were enough to turn off many respondents.

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.

Would doctors who take money from drug companies “always or almost always” be biased to prescribe that company’s drugs—even when they were no better and/or more expensive than an alternative drug? Yes, said 36 percent of poll respondents, while another 15 percent said doctors would be biased in this fashion “more than half the time.” Just 11 percent said doctors would  “never or almost never” be biased by a financial relationship.

When it comes to their personal physicians, Americans were more trusting than they were of doctors as a group. Almost 30 percent said their own doctors would “never or almost never” show such bias toward drug companies. Still, 26 percent agreed that even their own doctor would “always or almost always” be biased in favor of companies that pay them, and an additional 8 percent thought their own doctor would be biased “more than half the time.”

Do ask, do tell
Most Americans think that doctors who take drug company payments to promote their drugs to other doctors should fess up. Seventy percent think that doctors should tell their patients about payments they’ve received from a company whose drugs they are about to prescribe. But only 2 percent of respondents reported that in the previous five years a doctor they saw for medical treatment had actually disclosed that he or she had taken payments from drug companies. 

The ProPublica database gives a glimpse of the practice by combining data from seven drug companies. Many other pharmaceutical companies don’t yet disclose the names of doctors on their payroll, but all will be required to do so by 2013 under a provision in the health-reform law.  As more about these cozy relationships are revealed, consumers may become even more suspicious. In another recent Consumer Reports poll, we found that 69 percent of Americans think drug makers have too much influence on doctors’ decisions about which drug to prescribe. And the majority were also concerned about rewards drugmakers give to doctors for prescribing a lot of a drug, payments for testimonials or for serving as a company spokesperson for a given drug, payments for speaking at industry conferences, and paying for meals for doctors and their staffs. 

It’s time for Americans and their doctors to have a frank talk about drugs. More than half of those in our latest poll (54 percent) said they’d feel comfortable asking their doctor if he or she has taken payments from drug companies. And younger adults, under age 50, were more likely (59 percent) to feel comfortable having such a discussion with their doctor than older adults (49 percent).

It’s a conversation worth having, and disclosure of these sometimes-secret relationships is a good reason for involved doctors to come clean. In the past, we’ve suggested that consumers should look their doctors up on pharmaceutical company websites that list the doctors they pay. Now the ProPublica database has brought many of those sources together in one consumer-friendly package. Take a look, and-–whatever you find-–feel free to ask your doctor if he or she accepts any payments from drug companies.

—Kevin McCarthy, associate editor

Consumer Reports released this survey to coincide with ProPublica’s “Dollars for Doctors” report, and has joined with NPR, PBS Nightly Business Report, Boston Globe, and the Chicago Tribune to help inform the public about this investigation.

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