Industry spending on marketing to Vermont doctors and hospitals totaled $2.6 million in the 12 months ending July 1, 2009, which is when a new law took effect that is designed to reduce the flow of dollars, according to a report from Vermont attorney general William Sorrell. The spending, which was racked up by 85 drugmakers, was about $400,000 less than the previous years. The biggest spenders were Lilly, Pfizer, Forest Labs, Merck and GlaxoSmithKline.

“They’re going down, and they’ve been going down for a few years,” Sorrell tells Bloomberg News. “The question is whether their disclosure obligations are having an impact on that or whether they’re just changing their marketing strategies.”

The total dollars paid to doctors who individually received more than $3,000 decreased over the last two years by 12 percent, to $1.5 million for 102 physicians from $1.7 million to 104 physicians in fiscal year 2008. Of these, psychiatrists again received the greatest amount - nearly $380,000 in fiscal year 2009. Docs specializing in internal medicine, neurology, family practice and ionizing radiation privileges, received over $100,000 in total expenditures. The total paid to physician assistants, RNs and APRNs grew from about $100,000 to $288,000 over the last two years (see here).

A PhRMA official attributed the drop in spending to the sour economy and reorganized sales teams. “Most physicians are well-enough educated to recognize that they need to have information about how to use medicines,” Marjorie Powell, PhRMA’s senior assistant general counsel, tells Bloomberg. “I would be very surprised if any physician prescribes the medicine because somebody bought them a sandwich.”

Vermont’s law, which was passed in 2002, requires drugmakers to report spending on consulting, speaking, travel expenses, gifts and other goodies to docs, hospitals, universities and others authorized to prescribe drugs. Samples aren’t covered. Last year, Vermont passed changes that require drugmakers to publicly disclose doctors names and payments, and bans most gifts, including catered lunches. As Bloomberg notes, those changes weren’t included in time for the latest report.

Findings include… About 42 percent was for speaking fees and 12 percent went to continuing medical education grants. More than half the payments were in cash ($1.7 million) or checks ($1.4 million). About 30 percent of the total, or more than $800,000, was spent on food, and more than 20 percent of the people who had food bought for them got $1,000 worth or more. About 47 percent of the 2,769 licensed docs and nurses had expenditures associated with them.

“Our quick analysis would be that the suggestion of increased transparency and disclosure in the relationship between the pharmaceutical manufacturers and medical doctors is already beginning to have its initial impact,” Ken Libertoff, director of the Vermont Association for Mental Health, which favors tough disclosure requirements, tells Bloomberg.

Photo courtesy of Jerome Kassirer