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Doctors on Pharma Payroll: What Our Partners Found

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Dr. Merle Diamond, right, consults with a patient at the Diamond Headache Clinic on the North Side. Diamond received $148,300 this year and last, mostly for speaking on behalf of GlaxoSmithKline. “To me, it’s always been about helping physicians understand the treatments that are available for migraine,” Diamond said. (Chris Walker, Chicago Tribune)

The doctors handpicked by pharmaceutical companies as promotional speakers or consultants are supposed to be the most respected in their fields, but that’s not always the case, according to an investigation we launched today.

Using data culled from the disclosures made by seven major pharmaceutical companies, we found hundreds of doctors on drug company payrolls “who had been accused of misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.”

But that was just our focus. The project itself was a partnership with five other news organizations, NPR, the Chicago Tribune, the Boston Globe, Consumer Reports, and PBS’ Nightly Business Report. We assembled the database—tens of thousands of records totaling $257.8 million in payments from pharmaceutical companies to more than 17,000 doctors—and our collaborators had license to dig away. Here’s some of what they found:

The Chicago Tribune took the data for Illinois and contacted more than two dozen Illinois doctors who took home the most in drug-company cash. While most of the doctors told the Tribune they simply enjoy teaching others about new medications and research, accounts varied when describing how much control drug companies try to exert over these sponsored events:

"I enjoy teaching. I don't do it for the money,” Dr. David McNeil, a psychiatrist, told the Tribune. “The companies are very explicit that they don't want shills, advertisements, infomercials. They want us to discuss the research and a little bit from our practice."

Contrast that with what another Illinois psychiatrist said:

“In the last five years, it's become distinctly less interesting to me. To be given a slide set and be told this is what you can and cannot say was not exactly drawing on my expertise,” Dr. David Levine told the Tribune. Levine, who received $73,750 from Eli Lilly last year, said he’s not currently doing any speaking.

Our partners at the Boston Globe took a closer look at Harvard Medical School, whose doctors and researchers have collected almost half of the $6 million in drug-company cash that went to Massachusetts doctors.

Though some Massachusetts hospitals and academic institutions already have rules in place to crack down on such payments—particularly related to speaking events—enforcement is spotty, the Globe reported:

One of those physicians, Dr. Amjad Almahameed, a cardiologist at Beth Israel Deaconess and a Harvard instructor, was reported to have earned the third most among Massachusetts doctors, taking in $125,600 from GlaxoSmithKline. Almahameed declined to comment. Hospital spokesman Jerry Berger acknowledged that the doctor “may have given talks that were not in compliance,’’ but that he resigned from speakers bureaus in August.

Dr. Thomas Moore, associate provost for the Boston University medical campus, said the school is still reviewing doctors’ speaking engagements. But, he said, at least one doctor who spoke about doctor-patient relationships for Merck made up her own slides, and even though the company reviewed them, the school determined she controlled the material.

Other institutions, like Tufts Medical Center, do not require that the doctors control the content of their talks, but require that they agree with the material presented, the Globe noted.

Consumer Reports conducted a poll asking what Americans think about doctors who receive money from drug companies.  Despite many doctors’ assurances that the payments don’t influence how they practice, it’s still a topic that concerns many consumers:

About half of Americans said they would be concerned about the quality of care or advice from a doctor who accepted as little as $500 from a drug company, and two-thirds said they’d be concerned if a doctor took $5,000 or less. Most respondents (75 percent) were concerned about doctors who accept $25,000 or less.

To find out more about your own doctor, check our searchable database, which culled from the disclosures made by seven companies: Eli Lilly, Cephalon, AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck, and Pfizer.

Our partners at NPR have a helpful graphic of when these companies began making these disclosures and why. As it stands, while these companies in the database had a combined 36 percent share of the U.S. prescription drug market in 2009, they’re only seven of the more than 70 companies operating in the country.

Today and tomorrow, Nightly Business Report will be broadcasting this story as well. Be sure to check it out.

 

robert von bargen

Oct. 19, 2010, 5:23 p.m.

As usual, a fine job.  I worked as a “detail man” for three different drug companies for over 20 years.  In the old days, the people retained were even worse.  Family practitioners from Pickens Mississippi e.g. and a once famous doctor from Nevada named Elia, who wrote all kinds of articles for 2d rate journals.  The reprints were then used by the sales staffs.
Ironically, as a lawyer, defending doctors, I often worked with the plaintiffs’ lawyers to help nail the drug companies, since they were the deep pockets, unprotected from the limits California placed on judgments in Malpractice cases.

Narayanachar Murali, MD, FACP, FACG

Oct. 19, 2010, 10:11 p.m.

You have just scratched the surface. The greater corruption is in the device industry..Sometimes it is hard to know where the ethical boundaries are crossed. A whole group of doctors attending a national meeting could be presumed corrupted, if a device company sponsored a portion of a national meeting. What about those famous “unrestricted educational grants?”

FDA is corrupted( many reports). The main source of severe corruption is the congress and senate. The huge amounts of lobby money is nothing but legalized bribery. They have written it into law and hence cannot be challenged.

The latest massive attempted bribery ( which fortunately is not working well) is the HITECH act that has promised close too $60000 to doctors to buy certain electronic medical records software services from companies that are heavily invested into politics. The very notion that doctors can be persuaded to use something of no value to them, just because of promise of federal dollars is the most severe form of corruption..I wish Joann Silberner of NPR does some serious tracking of these money trails.

Yes, I’m a doctor. But no, unfortunately, I don’t get a dime from Pharma. I am hoping, however, to go to law school, run for office, and get some real pharma money! PAC money! I’ll become a congressman!

This is all a drop in the bucket compared to what they spend to buy our politiicians!

caffemaven, couldn’t agree with you more !! I really would love to go into politics, then vote to “legalize” the “incentives”!!

I guess it started with Eve when she gave Adam an apple and he did something for her.There have been ‘guilt trips’ all over the place ever since.The question is whether persons/doctors are compromised when given free dinners,vacations,devices etc-even desk sets.Some might feel obligated,others less so,some maybe not at all.Is the cop on the beat who gets a free apple from the fruit shop a criminal?I’ve seen police cars donated for police use by motor dealers..They even have a small sign on them indicating this. Surely the police are compromised-even the State Govt. for accepting this largesse. What happens when police stop the dealer DUI etc?

It is such a shallow fad to demonize pharma. I find the propublica articles rich in yellow journalism. For example, the paragraph, “About half of Americans said they would be concerned about the quality of care or advice from a doctor who accepted as little as $500 from a drug company . . .”  Such a survey would only be valid if it stipulated why the physician had received a payment.  A question eliciting an accurate response would read something like, “If your physician had participated in research or had experience with a certain drug and was asked to share that medical expertise with a group of her peers, would you be comfortable that she had received a payment of $1000 for delivering such a lecture? What if she did this once a month?”

Mary sullivan

Sep. 6, 2011, 8:50 p.m.

I know my my appointments with Doctor were cancelled several times due speaking commitments with Pharmaceutical companies. I was not given prescription refills due these involuntary changes. Switching physicians made complete sense.

Todd McCarthy

Oct. 7, 2011, 10:17 p.m.

Dr. McNeil is only interested in the income. One half hour to an hour = approximately $1,500 per speaking engagement. He can do 2 a day based on Lilly’s allowances. He favors prescribing their medications so he can profit, pocket and be a drug prostitute. He engages with the pretty Drug Reps. He needs a shrink

What a waste! McNeil’s waist is so large, all that food drug company reps feed him to buy his alliance, which pads his ass, oops, mean his pockets. All fat from the cow. He should be the next poster boy for weight watchers. The before picture. Never able to stop skimming off the top. A taker in the medical community. He resembles tweedle dum. Go to your primary care physician. Not nightmare McNeil.

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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.

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