ProPublica

Journalism in the Public Interest

Cancel

News Reports Cite Drop in Physician Speaking Fees

Regional newspapers that analyzed ProPublica’s Dollars for Docs data say drug company payments to physician speakers have declined in their states, suggesting that new restrictions and publicity are making an impact.

.

(Joe Raedle/Getty Images)

Amid increasing scrutiny, drug company payments to doctors for promotional speaking have dropped in several states, according to stories by several newspapers using our newly updated Dollars for Docs database.

The Boston Globe reported that payments by several drug companies fell in Massachusetts, “suggesting that new restrictions designed to distance doctors from industry are leading some to abandon the lucrative speaking circuit.”

Eli Lilly and Co., for example, spent $866,919 on Massachusetts health providers who spoke about its drugs last year, a 46 percent drop from 2009, the Globe reported. Payments from GlaxoSmithKline fell at least 29 percent to $884,850, but that underestimates the true decline because Glaxo did not publicly report payments in the first quarter of 2009.

"The data also show that many Harvard-affiliated doctors have dropped out of company speakers' bureaus, a sideline that has allowed many physicians to earn tens of thousands of dollars," the Globe reported.

Harvard-affiliated teaching hospitals barred promotional drug company speeches as of January 2010, and Harvard Medical School followed suit in July.

In our story yesterday, we noted how some drugmakers apparently have used fewer physician speakers and consultants since they began posting their data publicly. Cephalon, a relatively small Pennsylvania company that specializes in drugs for pain, cancer and the central nervous system, paid physicians nearly $9.3 million in 2009 for speaking and consulting. That figure dropped to $5 million last year.

AstraZeneca cut its spending on speakers from roughly $22.8 million in the first half of 2010 to about $9.2 million in the second half.

The St. Louis Post-Dispatch also notes decreases in payments to doctors in the St. Louis area.

Dr. James P. Crane, executive vice chancellor for clinical affairs and CEO of the faculty practice plan at Washington University, told the paper that the "amount of [drug company] activity is down" in general at the university.

The university revised its guidelines in January, requiring that faculty members have "final editorial discretion" over speeches they give for companies and materials presented. Companies had to write that stipulation into their contracts, Crane told the Post-Dispatch.

"We are now requiring our physicians to provide copies of industry contracts to make sure the language is included," he said. "We also sent the policy to 100 pharmaceutical companies letting them know we were making the change and asking them to respect it."

Four companies—Pfizer, Bristol-Myers Squibb, AstraZeneca and Sanofi-aventis—would not accept the policy change, Crane said, and faculty members were told to stop working with them.

The Denver Post reported that an ethics board at the University of Colorado School of Medicine “has rejected more than one-third of proposed contracts between doctors and drug companies since it took authority to approve the deals on June 1.”

The latest payment records show that University of Colorado faculty who “previously made the most from the drug companies” registered no payments in the latest quarters, the Post reported. The medical school dean said one doctor who earned more than $130,000 in 2009 and 2010 has decided on his own to stop taking the money.

Officials at National Jewish Health, a Denver hospital affiliated with the medical school, told the Post that they plan to post online all of their physicians' ties with drug companies.

Ron Berge, the hospital's chief operating officer, predicted that some National Jewish doctors would give up speaking because of the increased scrutiny. For those who continue, he told the Post, "I expect to see significant diminution" of payments.

ProPublica reported in May that the University of Colorado and Stanford were among several schools that took action to enforce or overhaul conflict-of-interest rules after Dollars for Docs data were first published last year.

Other newspapers highlighted local physicians who earned significant sums speaking or consulting for drugmakers.

The Orlando Sentinel spoke to Dr. Damon Tanton, an endocrinologist at Florida Hospital Celebration Health who earned $67,509 from Lilly. "I only speak for products I believe in," he told the paper. "I've turned down offers from companies asking me to speak on products I don't support."

The Plain Dealer in Cleveland spoke to Dr. Mark Mehle, an ear, nose and throat doctor who earned $234,900 in speaking fees. "The reason I'm high on the list is because I'm in demand," Mehle told the paper. "I'm a speaker people can bring in and actually get people to show up for it."

Mehle acknowledged that GlaxoSmithKline prepared the slides he used in some of his presentations, but he said that his ties to the company haven’t influenced how he treats his patients.

"You run into the appearance of conflict. No doubt about that," Mehle said. "But in all fairness, the vast majority of medications I write are generics. Ten to one generics over branded products. So I can tell you it doesn't affect what I prescribe."

Oregon Health & Science University's chief integrity officer, Gary Chiodo, told the Oregonian in Portland that scrutiny of the relationships between doctors and companies is healthy.

"There have been several studies now that even small gifts from industry to doctors influences their decision making," he said. "Even the smallest of gifts ... can influence prescribing practices. And certainly, when you get into the larger amounts, when someone is getting huge consulting fees for doing little work, the influence is great. All of that, of course, drives up the cost of health care."

Barry Schmittou

Sep. 8, 2011, 12:50 p.m.

Charles and Tracy,

Under your pictures you wrote :

“Got questions about medical ethics”

I do not know how to post to Facebook, so I am posting this for you here.

Obama and Bush’s DOL and DOJ Directors have allowed doctors’ paid by MetLife and other insurers to ignore brain lesions, Multiple Sclerosis, cardiac conditions of many patients, and a foot a new mother broke in five places as evidenced in the quotes from numerous U.S. Judges seen at http://www.deadlyorganizedcrimes.blogspot.com

(Please note in two separate cases Judges wrote that Dr. Gary Greenhood ignored Multiple Sclerosis and a foot a new mother broke in five places but Obama will not even ask him to stop !!

MetLife attacks multiple Psychological patients !!

In Zanny verses MetLife U.S. District Judge Richard Enslen wrote :

“Metlife and its henchmen should appreciate that such conduct may itself precipitate the suicide death of a person who has placed implicit trust in their organization. This record is an open indictment of MetLife’s practices and treatment of the mentally-ill and long-term disability benefits.”

Please remember the patients can die during the years it takes disabled patients to get their case to get to Court.

This is happening in multiple types of insurance. WFAA - TV wrote this about Workers Comp :

“a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care. Some insurance companies send peer review doctors medical files “stripped” of records important to the possible approval of workers’ comp claims.”

You can also see how multiple insurance companies are committing identical dangerous crimes at treasonevidence.blogspot.com

aI was referred to Psychologist while MetLife ignored my LTD claim for right eye cancer and left eye orbital surgery for six years. MetLife knew I often had no money for medical treatment. My life and my mind have been destroyed !!

The full reports can be seen at : mypsychologistsreport.blogspot.com

Please note that I have included quotes from ProPublica about injured war Zone Contractors on treasonevidence.blogspot.com

The above comment seems irrevelant to these issues.

Barry Schmittou

Sep. 8, 2011, 1:27 p.m.

John Kamp who commented above has an email at the Wiley Rein law firm that represents Pharmaceutical companies. Here’s a quote from their website :

“For more than two decades Wiley Rein attorneys have represented health plans, health care providers, pharmaceutical companies and other health-related entities in connection with federal and state health care programs, as well as with the application of federal law to commercial health businesses.”

Mr . Kamp’s email there is .(JavaScript must be enabled to view this email address)

I believe his connection to Pharmaceutical companies should be disclosed since Mr. Kamp’s comment on another ProPublica article about Pharmaceuticals said :

”Reporters wishing to provide more context and meaning to these stories should contact doctors with experience”

Kamp’s comment can be seen at http://www.propublica.org/article/piercing-the-veil-more-drug-companies-reveal-payments-to-doctors

You will notice in the comments on that article I asked Mr. Kamp for help. I emailed the request to him too.

You will also notice that on my comment above I wrote that I’m unable to post on Facebook so I’m asking a question here.

I’ve had cancer burned from one eye and surgery where the other eye was removed from the socket and a large mass and bone connected to the brain was removed.

But there’s no empathy or consideration from Mr. Kamp, who did not disclose that he works for a law firm whose website writes :

“For more than two decades Wiley Rein attorneys have represented health plans, health care providers, pharmaceutical companies and other health-related entities in connection with federal and state health care programs, as well as with the application of federal law to commercial health businesses.”

The real issue is whether patient care improved as a result of doctors receiving fewer fees or speaking less.  Can anyone point to evidence, statistical or anecdotal, to show any improvement in care?

Carolyn Thomas

Sep. 8, 2011, 2:23 p.m.

Jim, you may be missing the point here.  The REAL issue is if it’s appropriate for docs to be on the take from drug or device manufacturers, however that looks. 

Reminds me of the interesting study reported in the NEJM a couple years ago, in which researchers looked at all surgeons doing presentations at the March 2008 annual meeting of the American Academy of Orthopedic Surgeons. They asked these surgeons if they had received any payments from five companies that make hip and knee replacements, and then they compared the surgeons’ answers with the actual list of surgeons’ payments (about $270 million that year) provided by the five companies themselves (disclosure that was required in 2007 in order to avoid further legal action for “violating anti-kickback laws”).

Well, it turns out that researchers found that among 344 cash payments to surgeons disclosed by the five companies, only 245 of these payments were disclosed by the recipients. This means 29% of payments were not properly disclosed by the docs.

For the sake of clarity, let’s just call this ‘lying’.

In fact, more than $4 million in payments directly related to the subjects of the surgeons’ conference presentations were not even disclosed. 

That’s $4 million worth of very effective targeted product marketing for the device companies. And THAT is the issue. More on this at: “Is Your Surgeon Able to Understand Simple Instructions” at
http://ethicalnag.org/2009/10/10/orthopedic-surgeon-kickbacks/

This article is part of an ongoing investigation:
Dollars for Doctors

Dollars for Doctors: How Industry Money Reaches Physicians

ProPublica is tracking the financial ties between doctors and medical companies.

The Story So Far

ProPublica is investigating the financial ties between the medical community and the drug and device industry. In October 2010, ProPublica compiled the list of payments that drug companies make to physicians and built a publicly searchable database so that patients could look up their doctors.

Get Updates

Stay on top of what we’re working on by subscribing to our email digest.

optional

Our Hottest Stories

  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •