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Chatting With the Reporters Behind Dollars for Docs

Charlie Ornstein and Tracy Weber talk about the money docs get from drug companies, and why it matters.

Since 2010, ProPublica reporters Charles Ornstein and Tracy Weber have been investigating the influence of pharmaceutical companies on medicine. Their reporting exposed the financial ties between medical societies and drug and device makers, led to the tightening of conflict-of-interest policies at universities and ignited debate over these relationships.

We asked them to share some of their findings with our recently started Patient Harm Facebook community, and we are sharing it here as well.

1. How common is it for doctors to get money from drug companies?

Until recently, drug companies considered this a trade secret and didn’t release it, other than vague disclosures in lectures or medical journals. That changed a couple years ago as companies began settling federal whistleblower lawsuits (http://bit.ly/JQfalZ) alleging that companies unlawfully marketed their products for uses not allowed by the U.S. Food and Drug Administration (FDA).

In 2011, a dozen drug companies released some information about their payments to doctors. Although they represent about 40 percent of U.S. prescription drug sales, there are dozens or hundreds of companies out there that have yet to disclose this information. These records show that hundreds of thousands of doctors receive money, meals and educational items to speak or consult on behalf of these companies.

2. How much money are we talking about?

$761 million in disclosed payments so far.

3. Why are doctors getting money from pharmaceutical companies and why is that allowed?

Doctor relationships with drug companies can take many forms, some of which are vital to the drug discovery process. Doctors can conduct research or clinical trials on behalf of companies, consult with them, deliver promotional talks on their behalf, and more.

Federal law prohibits direct kickbacks or rewards from companies to doctors to prescribe their products. The government also requires that when doctors do promotional speaking for drug companies, they must follow the same rules as the companies and may not promote the products for uses that are not authorized by the FDA. So, doctors often use company produced slides and talking points to guide their presentation. Doctors, however, may legally prescribe drugs for any reason they want, even if the use is not FDA approved.

4. How do I find out if my doctor is getting money from drug makers?

Search Dollars for Docs on ProPublica’s website, where our colleague Dan Nguyen pulled all of the information together: http://projects.propublica.org/docdollars/.

5. Should I be concerned if my doctor is getting this money?

This is a personal decision. You certainly have the right to ask your doctor about a payment and what he/she did to receive it. Some patients have told us that they feel more confident about their doctors knowing that companies consider them experts. Other patients have said that the payments raise doubts about their doctor because they don’t know whether the drugs they are receiving are appropriate for them. Talking to your doctor is a good idea.

What should I do if my doctor is getting drug company money?

One of our colleagues put together a list of questions that you can ask your doctor. These include asking about a drug’s side effects, whether a cheaper version is available and whether there are non-drug alternatives that you can try first.

6. What are you working on now?

We are curious about doctors’ prescribing practices and whether patients have concerns about drugs that were prescribed to them by their doctors. Were the drugs you were prescribed appropriate, both therapeutically and financially? Let us know. Our emails are [email protected] and [email protected].

If you or a loved one has been harmed while undergoing medical care, you can also contribute to our reporting by filling out our Patient Harm Questionnaire.

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