Secret Pharma Payments To Vermont Docs Disclosed
8 CommentsBy Ed Silverman // November 4th, 2008 // 4:01 pm
Payments by drugmakers to Vermont docs between July 2002 and June 2004 totaled more than $4.9 million, much more than the $2.7 million that was previously reported by Public Citizen in an article in the Journal of the American Medical Association in March 2007, the advocacy group now says.
The payment details were hidden by 21 drugmakers that designated the data as trade secrets, according to Public Citizen, which says it obtained the data through litigation and released an updated analysis, including the newly obtained data. The new material was published in a letter today in JAMA, and is a follow-up to Public Citizen’s testimony last year before the Senate Committee on Aging.
Three years ago, the advocacy group sued the Vermont attorney general and the drugmakers to unseal info about the payments. In a statement today, Public Citizen says these comprised 43 percent of all payments (9,182 of 21,409) and 56 percent of all dollars ($2.72 million of $4.90 million) paid to docs in the state. Among the drugmakers involved were Abbott Labs, AstraZeneca, Sanofi-Aventis, Bayer, Bristol-Myers Squibb, Roche, Lilly, Merck and Glaxo.
One of the key findings is that Vermont’s docs received $3.2 million in payments over $100 from drugmakers, 86 percent of all such payments to health care providers. Public Citizen maintains these “strongly suggest” frequent violations of professional guidelines issued by the American Medical Association and PhRMA, both of which prohibit many gifts from exceeding $100.
“Patients should be able to find out which drug and medical device companies are paying their doctors and how much,” Peter Lurie, deputy director of Public Citizen’s Health Research Group, in the statement. “If doctors and drug companies don’t feel comfortable about making the relationships public, they ought to reconsider the relationship itself.”
Doug Bremner
Physicians make a lot of money. Why don’t they just pay for their own damn talks?
Dan A.
Consider this:
This is one state. Take into account the demographics of other states, and the diseases that are most prevalent at various locations. It’s more money paid to doctors, et. al. than one could possibly imagine, I believe with the experiences I have had with this industry.
As a former drug rep with big pharma, I never had a limit on who I bought in the ten years I was involved with this vocation. In fact, I received larger raises per year that directly and specifically correlated with the amount of money I gave to prescribers. The more I spent from my employer to doctors, the more I made. This is common with all big pharma companies.
Keisha B.
This is to Dan A. and anyone else dealing with ‘Big Pharma’..I know you people realize what you are doing to other citizens, so why do you do it? I will say thank you to Dan A. for saying what he said about giving money and making money though. It just deeply sadens me that (in my strong opinion) you people don’t seem to care about how much harm is being done to innocent and wonderful people by you all doing what you do. Why is money the center of all evil? :(
Peter
To Dan A and Keisha. Dan you’re full of crap and Keisha you are just naive. This article does not even mention what constitutes “gifts” and I’m sure that is intentional because usually when the details come out it doesn’t seem quite so horrible and then it would not be a news story. Often Times in order to get face time with a physician to detail(provide information about) a product reps have to buy lunch for the office. The total cost for these lunchs are assigned to the physicians present and sometimes that number is very high. An example would be an office with 20 staffers including nurses, nurses aids, therapists etc. but only one physician attends the lunch. if $140 was spent($7 per person) then the one physician is allocated the entire value of the meal. At $7/head he isn’t eating caviar, but he/she and alot of the staff are gaining valuable information about how and where a product or products should or should not be used and what important side effects to look for and how to manage those side effects should they occur. Now Keisha, if you are prescribed something from your doctor wouldn’t you want her to know everything she should about that medicine?
Ed Silverman
Hi Peter,
With all due respect, there was nothing intentional about the lack of a definition for ‘gifts.’ The issue of payments is discussed, actually, in the original 2007 JAMA paper referred to in this post. However, I was only able to include a link to the abstract, because a subscription may be required to access the entire article. However, the following is from the introduction section…
“Interactions between the pharmaceutical industry and health care professionals often involve payments: cash payments; cash-value payments, such as gift certificates; or in-kind payments, such as meals, textbooks, conference fees, or luggage. In contrast to many other professions, including education and law, medicine allows payments from a company to an individual who decides whether and how often to use products produced by the company. To avoid undue influence, the American Medical Association recommends that gifts (but not other payments) to physicians should benefit patients and not exceed $100 in value, a recommendation similar to those of other medical organizations and the Pharmaceutical Research and Manufacturers of America. Other individuals have proposed eliminating all direct payments…
“We sought to determine the accessibility and quality of the data available in Vermont and Minnesota through their payment disclosure laws and to describe the prevalence and magnitude of disclosed payments of $100 and more…”
The authors also referred to the AMA guidelines, which you can read here…
http://www.ama-assn.org/ama/pub/category/4001.html
There was no effort on my part to dress up this post to create a ‘horrible’ impression. I was simply reporting a development involving an ongoing story. In this case, the advocacy group filed suit against the Vermont AG and the 21 drugmakers over disclosure of data, reached a settlement (which allows it access to the data each year) and, then, released updated info based on its analysis of the recently obtained data.
I hope this helps,
ed
atlex
Ed,
Peter has a point. I don’t think you are dressing this up to create this impression, I believe that Public Citizen intentionally blurs the terms “gift” and “payment” so they can make it look as though Pharma is giving millions of dollars in gifts. In reality, the majority of payments are for services performed (speakers fees, consulting, etc.). I seriously doubt that there are significant violations of either the AMA or PhRMA guidelines.
Atlex
Ed Silverman
Hi Atlex,
Understood. I wasn’t attempting to be argumentative. And I don’t know if your interpretation is correct. Perhaps at the end of the day, the dollar value of whatever was given - cash or whatever - was the focus here.
Cheers
ed
Rob McWaters
As a receiver of drugs prescribed by my health care providers I have a good amount of faith in what they prescribe for me. I do expect them to be aware of any potential side affects versus the good those drugs could do in my individual circumstances. Most business sales persons dealing with clients offer gifts of some kind to foster good will.
Why should doctors by single out? I believe this is petty stuff. How else are doctors supposed to learn about new drugs? They are not obligated to use any drugs just because they listened and learned. They still make their own judgments.