A total of 84 drugmakers spent more than $3 million dollars in Vermont in fiscal 2007 to influence sales, a 33 percent increase over the previous year and a 42 percent jump from two years ago, according to a report issued by the state’s attorney general. The money was used to pay for fees, travel expenses, gifts and other items to docs, hospitals, universities and others for marketing purposes.

The top five spenders were Lilly, Pfizer, UCB, Novartis and Merck, and payments by these drugmakers represented 56 percent of the total amount reported by the 84 drugmakers that filed disclosures, according to the AG report. And four of the five most heavily marketed drugs are used to treat either ADHD or depression, the report found.

“This report shows, once again, that the pharmaceutical industry has too much influence over the practice of medicine in Vermont,” Vermont AG Bill Sorrell says in a statement. “It is particularly troubling that the industry is paying large sums of money to influence prescribing practices involving psychiatric drugs.”

The top 100 recipients received more than $2 million, or 68 percent of the total payments. Of the top 100 recipients, psychiatrists received the highest level of payments, and 11 psychiatrists received a total of about $626,000, or approximately 20 percent of the total value of payments. The average amount received by psychiatrists was nearly $57,000.

Physicians specializing in cardiovascular disease received the second largest aggregate amount among the top 100 recipients. Two prescribers received a total of $312,898. Physicians specializing in internal medicine received the third largest aggregate amount among the top 100 recipients, with 21 prescribers receiving a total of $277,385, or an average of $13,209.

The report, which was criticized by PhRMA, also found that the top 20 drugs represented 7 percent of all drugs for which disclosures were reported, but accounted for 62 percent of total marketing expenditures on specific drugs. (The list of the top 10 drugs is to the left). Here is the report.

Ken Johnson, PhRMA’s senior vp, tells The Rutland Herald that the AG’s report is “misleading” and that the data “serve only to misconstrue the value of interactions between pharmaceutical research companies and health care professionals.”

“The current statute in Vermont does not acknowledge that meetings with technically trained pharmaceutical research company representatives - many of whom are health care professionals themselves - are one of several important ways for physicians to receive the information they need to make sure medicines are used properly and patients are safely and effectively treated.”

Meanwhile, Ken Libertoff, executive director of the Vermont Association for Mental Health, worries that financial incentives are playing a role in prescribing decisions, and called on the Vermont Medical Society and Vermont Psychiatric Association to formulate official policies directing doctors to decline any future payments.

“This report confirms that there’s been an enormous intrusion of pharmaceutical marketing and pharmaceutical gifts to physicians throughout the state,” Libertoff tells the Herald. “…The mixture of marketing and money and medicine is a formula for disaster, and we think that this report confirms concerns about whether consumers and patients are receiving the best care and the best practice.”