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How the Drug Companies Say They Screen Their Speaker Docs

The seven drug companies that have disclosed their payments to doctors say they screen their “speakers” but many do not check state medical disciplinary databases.

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As part of our Dollars for Docs series, ProPublica asked the seven pharmaceutical companies that have so far disclosed payments to physicians how they check the backgrounds of their speakers and consultants. Our own review of physician licensing records in 18 states found sanctions against more than 250 doctors. Some had lost their licenses.

Specifically, we wanted to know whether the firms looked up potential speakers on the websites of state medical board to determine if they had been disciplined. Only two said they routinely check these sites, even though these boards are the front-line regulators for the profession. Here is what the companies said in written statements and interviews.

AstraZeneca: Requires speakers to sign a contract in which they attest that they have not “engaged in conduct that has resulted or may result in a felony conviction” and that they are not excluded, debarred, suspended or otherwise ineligible to participate in federal health care programs, federal procurement, or non-procurement programs.

Marie Martino, the company’s U.S. compliance officer, said the company checks the exclusions database at the start of each engagement. As for checking state disciplinary actions, she said, “We check that as the need arises. If we become aware of say a media story that would raise some issue about an individual, we check first of all to see are we engaging that individual as a speaker or a consultant or in any capacity and then we evaluate that further.”

Cephalon: As part of its selection process, it checks for debarments, as well as state and U.S. Drug Enforcement Administration licensure.

Eli Lilly and Co.: “Lilly strives to hold our contracted speakers to the highest ethical standards. We actively monitor — daily — federal debarment lists, including: the Health and Human Services/Office of Inspector General List of Excluded Individuals/Entities; and General Services Administration's List of Parties Excluded from Federal Programs.

“If an individual has been excluded, debarred suspended or otherwise ruled ineligible to participate in federal health care programs, we would likely catch it in our daily monitoring and terminate the contract with that individual immediately. 

“Additionally, each speaker must sign and return to us a contract stipulating that they are in good standing with licensing and other health care and legal authorities … If we are made aware that someone has been debarred, we would initiate a review process that could result in termination of the contract.

“Recently, we have also moved to institute a process to affirmatively evaluate the credentials of our speakers every other year to ensure they have maintained their qualifications to speak for the company.”

GlaxoSmithKline: “Speakers for GSK sign a contract in which they must certify that they are not excluded, debarred or suspended and that they are not about to be excluded, debarred or suspended. Exclusion and debarment checks are performed prior to contracts being sent and are rechecked each month. GSK currently limits its review to exclusion and debarment at the federal level and does not currently assess discipline at the state level.”

Johnson & Johnson: “In general, our company has developed criteria regarding speaker qualifications including: Checking with State Medical Board websites, federal exclusionary databases maintained by the Office of Inspector General and the Excluded Parties List System …

“Speakers that do not meet our requirements for participation (listed above) are removed from our speaker bureau. If we become aware of a change to a consultant’s status for qualification, he or she is removed from our speaker bureau.”

 

Merck: "As part of our evaluation of potential speakers, each candidate must review and agree to the terms of the Speaker/Moderator Agreement Letter which includes: 1) Confirming that speaking at a Merck program would not raise a conflict of interest; 2) Reporting to Merck if they are excluded from certain government programs; and 3) Merck's right to terminate a speaker's agreement for unethical behavior. We also check all candidates against the U.S. government's Excluded Parties List (EPLS), Office of Foreign Asset Control (OFAC) and Office of Inspector General (OIG) database." 

A spokesman said the company does not routinely check physicians against state board websites. “We do background checks at the time we contract and then annually. We are currently evaluating our processes and expect to take additional measures beginning in 2011.”

Pfizer: “Pfizer ensures the healthcare providers we work with are in good standing with the Department of Health & Human Services Office of Inspector General (OIG), the Food & Drug Administration (FDA) and the U.S. General Services Administration (GSA).

“Due to the disparity of available information, we currently do not actively screen against state or institution disciplinary actions, although when we learn of violations, we will review and determine whether termination of a speaker from our speaker bureau is warranted. We are continually reviewing our process to ensure we are selecting the most appropriate speakers and are currently assessing potential enhancements to our process. “

You can check here to see if your doctors have received money from these drug companies.

where can i find the search button in this site?

THANK YOU FOR YOUR GREAT WORK ON BEHALF OF THE AMERICAN PATIENTS!


I AM LOOKING FORWARD TO THE DAY WHEN ALL PRACTITIONERS OF MEDICINE, PHARMACOLOGY, NURSING, STOMATOLOGY, OR PSYCHIATRY WILL FULLY DISCLOSE ALL THEIR INVOLVEMENT IN RESEARCH AND ALL ASSOCIATIONS THEY HAVE WITH DRUG OR MEDICAL DEVICE COMPANIES, OR GOVERNMENTAL AGENCIES PAYING FOR OR CONDUCTING SUCH RESEARCH.
IT WOULD ALSO BE USEFUL FOR THE CURRENT STUDY TO INCLUDE A SEPARATE COLUMN SHOWING THE SPECIALTY OF THE DOCTORS LISTED.

John Henry Bicycle Lucas

Oct. 20, 2010, 7:51 p.m.

So, Mr. Orstien, how have you improved the quality of people’s lives today? How many bandaids, how many asprin did you produce? How many heart attacks did you prevent, or do you even know CPR?


I’m sure I can be critical and search your past articles and crossmatch references till I provide another institiution of media that you are not credible at all. To bad people don’t need a license to be a journalist. Maybe you will become a mere “writer” again soon, and we won’t have to read your propoganda against an industry that has made this country one of the leaders in the world in medicine and the only country that even rivals us is India in the medical field, in my humble opinion.

I’m sorry, but this story is like filler material only.

Grumpa Oldfart

Oct. 20, 2010, 8:39 p.m.

Apparently Mr. Henry thinks it is ok that doctors act as shills for drug companies. Is Mr. Henry aware that not only do they push specific drugs for treatments but they push the same drugs for treatments NOT approved by the FDA? That, in fact, their job is not to HEAL but to PUSH drugs. Whether they work or not.

In Mr. Henry’s universe doctors are always the good guys and drug companies always have everyone’s best interest at heart. Unfortunately, that is NOT the real world where doctors are often the bad guys and drug companies care only about the bottom line.

Mr. Henry needs to grow up and pay attention.

John Henry Bicycle Lucas

Oct. 21, 2010, 5:24 a.m.

Mr. Grumpy, I know that pass through marketing worked very well for many years, you would go to your Doctor, he would diagnose your problem and recomend treatment.

Now, we have drug companies doing direct marketing on the other idiot box in our homes. (That’s TV to you)

The FDA takes our tax dollars and is supposed to prevent us from being poisioned by our drug companies, chemist, and Doctors.

Grumpy, we are probably very much alike in our line of thinking, only our antennae are pointed in a little different direction is all. These drug companies send Doctors on trips for doing business with them, it is our “take a pill for it” system that is set up. Just like the Flintstone Cartoons, and the Jetsons.


In this age of digital communications today, we can
share information much faster, or misinformation as well. We can sway the path of the thinking of some by having a forum and calling ourselves journalist, or we can be a voice, crying in the wilderness…

Take care. And may God Bless.

These articles are insane. In the “information” age, anyone can get on the computer and see if the medications prescribed are actually indicated for their diagnoses.  Irresponsible reports like this are increasing non-compliance amongst patients as they feel that all doctors prescribe meds for personal benefit.  Medicine is the only profession that toils to end its own existence - disease.

Grace Whorton

Oct. 21, 2010, 5:40 p.m.

Yes, I agree that to a large majority of people, this is the “information” age. NOT everyone is able to have access to a computer, whether it be they can’t afford one, or are able to go use one away from home, etc. That is not the problem. The problem is, the average citizen probably doesn’t even know this type of thing even goes on. I saw it on our local news, or I would not have know. I would much rather see a doctor that knows the truth about a medication (as much as can be known) than one who is paid to “sell” it. I appreciate the article.

John Henry Bicycle Lucas

Oct. 21, 2010, 6:20 p.m.

When we go to visit our Doctor, what are we paying for? There are many costs associated with being in business, as most family Doctors are in a PC. These people have a huge overhead, you have no idea, but I do.

Our medical system works, and it works well. It is expensive, certainly, but being foremost in the entire world is expensive. There is constant research going on by the large phamacuticals as I type. Yes, they use animals in the research. Yes these animals die sometimes during the process.

Get over it, PETA.

I love my pets as much as anyone, but what is my son’s life compared to them? Or my daughter’s life, compared to my pets?

We have become a lazy, I’m entitled country full of fingerpointing people and those seeking to sue someone in court. That is what the #1 cause of high healthcare costs is.

Oh, did I get on a rant? Sorry. Maybe I have adult ADD or even ADHD…maybe I should go take a pill.

I value my Doctors greatly and their skill. I have had three spinal fusions, one ulnar nerve relocation, one knee surgery, and other health problems as well, including heart problems, yet I work every day, and I know others that do, too with as many problems as I have. I need my self esteem, oh yes and money is nice too.

Sometimes I wonder what happened to people 100 years ago before medicine was as advanced as it is now. I would probably have wound up as a drunkard or addicted to some narcotic. Now we have institutions of education that produce people that have the skills to do so many things that were only science fiction 35 years ago. I’m able to walk today due to dedicated people that knew what they were doing.

This kind of quality of life is valuable, and costly. If a drug company makes money on it, I’m fine with it, everyone has to eat something.

Think about it.

Reading “White Coat, Black Hat.” Good info on human Guinea Pigs paid for drug trials.

arnold kleinmd

Oct. 22, 2010, 3:21 a.m.

In 2005, four hundred thirty six “serious adverse event” reports related to Botox® had been
reported to Allergan, the manufacturer of Botox®. Two hundred one of these cases were
possibly or probably due to remote spread of the toxin, including 42 cases reported after wrinkle
injections. Also in 2005, Allergan had reported to the FDA that they had identified 38 patients—
20 children, most of them with cerebral palsy, and 18 adults—who had suffered seizures after Botox® injections.
During May 2007, European regulators requested that Allergan and two other toxin competitors
add information to their product labels and to warn doctors that the toxin could spread, causing
botulism like symptoms (dry mouth, difficulty swallowing, blurred or double vision, drooping
eyelids, slurred speech and progressive muscle weakness). In July of that same year a
confidential report made to Allergan by a consulting firm showed 207 patients had developed
medical problems associated with the spread of toxin, including several deaths. A third of the
cases reported occurred in people treated for wrinkles. The rest were treated for muscle spasms,
muscle spasticity and eye problems. Proportionately more problems were reported amongst
children who had received Botox.
    The accurate and safe usage of this
toxin becomes problematic when a physician’s or injector’s expertise and knowledge become
\. However, the Food and Drug Administration is presently investigating isolated cases of
generalized weakness resulting in poor outcomes.”
I think that rather than use words like “poor outcomes”; it would be more accurate to use the
word “deaths.” Indeed, in Orange County, California, there was a trial concerning the death of a seven-year-old girl after she was treated with Botox®, While it will reduce
spasticity of the leg and arm muscles in individuals with cerebral palsy, the question that must be
answered is “Is it safe?” How does Allergan educate physicians for the use of this product for cerebral palsy when it isn ot approved for this indication? Allergan, through its extensive chain of paid consultants, has
created a vast array of courses they sponsor through assorted CME (Continuing Medical Education) programs. This is not widely known outside of a select medical community. The FDA has seemingly turned a blind eye toward Allergan’s off-label promotion.
.  Recenly Allergan paid 631 million dollarsfor off =label promotion but within days got their money back because it was approved for migraine. Furhermorethese courses continue. Who teaches these courses. The lead speakers are usually officers of medical societies who are paid up to $10,000 or more per lecture. Their main cosmetic teachers and injecors were Jean and Alasrair Carruthers who prevented me from speaking at meeings even though neither had a license or a green card
(the were from Canada).With the help of their friends Gary Monheit, Rhoda Narins,Michael Kane, Zoe Draelos and others they published altered data and prevented me from even giving a lecture when I pioneered the field of injectables. These are the folks you read about in W and Allure because advertising money talks,. But now I plan to use every means possible to tell the truth and properly educate the public and physicians about All injectables ,,,is not time for integrity rather than greed.
            Arnold William Kleinmd
            Professor of Medicine and
            Dermatology UCLA
            Consultant, Device Panel, FDA

John Henry Bicycle Lucas

Oct. 22, 2010, 4:56 a.m.

We thank you Doctor Kleinmd. A person has have their head in the sand, or a posterior region of their own anatomy not to know Botox is poision.

So just how much of our tax money is going to you for your consult advice?

Dr Arnold W Klein

Oct. 22, 2010, 3:57 p.m.

i have never been paid by the government nor am I a consultant to any drug company.  You obviously do not understand what a consultant for the FDA does. Also, I have raised over $270 million dollars for AIDS and set up a fund for breast cancer and a center Aids treatment at UCLA. Furthermore I am involved with the group that found the first gene.

What have you done to make this world a better place?

John Henry Bicycle Lucas

Oct. 22, 2010, 5:14 p.m.

Suffice to say my dear Doctor you must understand that I too, am in education, only on a different level, so to speak. I have taught on the post secondary level and have many letters I can put behind my name as well as you do.

You sir, if you do consult for anyone, you do have a consumer. That being the University of Southern California, right? So in esscence the UCLA has an independant charter? Has UCLA never recived any tax dollars? You work in the government school system just as I do dear sir.

You evidently voted differently than I did in some of our recent elections in this country.

You obviously are educated beyond your own intelligence, and have a very thin skin to match your frontal lobe matter in the course of reasoning and judgment of people.

A consultant merely tells someone how they should do something. Does not mean they can do it.

I think you really need to get yourself a hobby, Doc.

I tell you what, let’s exchange positions for one month. I’ll do what you do and you do what I do.

Arnold KleinMD

Oct. 22, 2010, 8:17 p.m.

Dear Mr Bicycle,
Suffice it to say I do not receive income from UCLA or USC. However I do in fact have the Arnold William KleinMD Chair in Dermatology at UCLA for which I raised over $ 1.2 million dollars. My hobby and life is medicine 24 hours a day 7 days a week. I love medicine and feel you are are trying to find a hole in what i do. If passion and integrity are holes or possibly believing what I do has to the best there is…then sir I have lots of them.  Arnold KleinMD

John Henry Bicycle Lucas

Oct. 22, 2010, 8:28 p.m.

The last name is Lucas.

Just as I said, educated beyond your own intelligence.

Peter Wasserman

Oct. 22, 2010, 9:41 p.m.

Dr. Klein,

Thank you for taking the time to share your expertise with us and your other good works.

Clearly, there are problems at the FDA and other regulatory agencies. This is likely the result of electing people to government office who feel it (government) is a “problem” instead of a tool with which to better the lives of citizens.

Joseph Califano

Oct. 27, 2010, 12:44 p.m.

Why so angry, Bicycle? I agree with your support of the medical profession, but you are beating everyone up here.

Dear John Henry Bicycle Lucas,
If you had a serious point to make, it was completely lost in your ranting and personal attacks. If you want people to take you seriously, it is best to attempt to communicate on an adult level.

Samuel Hunter

Nov. 10, 2010, 8:26 a.m.

This crazy yellow journalism is guaranteed to hamper the cross pollination of academia with industry. The pharmaceutical companies have been nearly the sole source of innovation which has improved lives and brought increasingly safe and affective therapy. To say that pharma influences doctors by paying them to do work is silly. Physicians have the interests of the patients at heart and the majority of money is to conduct the research which provides the knowledge we all have to rely on. If you don’t want the pharmaceutical industry in touch with the needs of medicine, and to have the resources to make progress, just keep getting in the way NPR.

@Samuel Hunter: Ah, another Ode to Pharma.

Pharma is an interesting industry because it perpetuates its own internal conflict of interest. On the one hand you have the researchers who have quite literally changed the world through their innovations. No one would dispute that this research, and the process of moving a new drug through FDA approval, are expensive. But on the other hand you have the fact that these are publicly-traded companies pushing hard to provide value to their stockholders. Not only must they support the high costs of R&D and FDA approval, they must turn a profit quarter over quarter. The potential for conflict comes when the company asks itself “how do I increase sales of this product?” It’s pretty clear that at least some pharma executives have made poor ethical choices in that regard, paying physicians to promote ther products in commercials dressed up to look like academic lectures. And some physicians have been all too willing to play their part in the charade.

How could you possibly label an effort to expose this practice “yellow journalism?” Do you even know what that term means? As I’ve mentioned in another comment on a related article, one can only legitimately consider these pharma-sponsored drug talks part of academia if you can get college credit for watching a Shake Weight infomercial.

The phrase “cross pollination of academia with industry” is very fine-sounding, and I am all for open exchange between academia and industry. But that is not what this is. This is corporations working hard to leverage practicing professionals as marketing tools.

Your argument is just another straw man scenario. In fact, the vast majority of objections I’ve seen presented regarding this series of articles have been logically fallacious. It really, really gets old. I’m beginning to think our society is losing the ability to directly debate an issue without introducing ad hominem, straw man, or false dilemma fallacies into the discussion.

Samuel Hunter, MD, PhD

Nov. 14, 2010, 1:17 p.m.

I know exactly what yellow journalism. Salacious, msileading, and designed to grab headlines with misleading the public. So the arts wouldn’t exist except for the patrons, and safe effective therapies would not except for pharma, and doctors wouldn’t know how to use them except for professional education which is funded by pharma and very well balanced in virtually every case I have seen in 10 years prior. The regulators are going after deep pocket big pharma to try and extract billions in fines, which truly harms research and education. Shame on you all.

John Henry Bicycle Lucas

Nov. 14, 2010, 1:42 p.m.

I’m sorry if I offended anyone.

But I certainly agree with Dr. Hunter.
I am not sorry for that.

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