How Much is Big Pharma Paying Your Doctor?

Pharmaceutical company reps are a common sight at physician practices.
Pharmaceutical company reps are a common sight at physician practices.
Most of us have been in a doctor’s waiting room and seen a well-dressed businessman or woman walk in with a briefcase and be escorted through the reception doors, presumably to the doctor’s actual office. These are pharmaceutical company representatives, and their job is to provide information to physicians about their products.

They may offer samples of the product for the doctor to give patients who can’t afford medication, or they may hand out various trinkets like neckties, pens, and badge holders. What you may not know is that pharmaceutical companies spend $60 billion on physician marketing every year, and from 2009 to 2012, 15 drug makers spent more than $2 billion in payments directly to physicians for consulting, research, travel, and promotional speaking,.

Today Vs. a Decade Ago

Believe it or not, things are better than they were five or ten years ago, when pharmaceutical companies paid for lavish “conferences” on cruise ships and in luxurious tropical destinations where physicians were wined and dined by big pharma representatives. But while those practices are rare today, pharmaceutical manufacturers still ply physicians with gifts and cash in exchange for speaking engagements. This type of paid promotional speaking is legal, though many people see a conflict of interest: can a doctor who is being paid by a drug manufacturer always put patient interests ahead of loyalty to those manufacturers? Doctors and pharmaceutical companies are adamant that such payments are not kickbacks, but some healthcare facilities are cracking down on the practice for fear of harming their reputations.

What You Can Learn Now

Right now you can go to a database compiled by Pro Publica, descriptively named “Dollars for Docs.” There, you can type in the name and location of a physician and find information about whether he or she has received payments from pharmaceutical companies. If your search doesn’t turn up anything, it doesn’t mean your physician hasn’t been paid by drug companies, because the database only includes information from 15 drug makers that accounted for around 47% of prescription drug sales in the US in 2011. Data on hundreds of thousands of physicians is included in the database, however.

What You’ll Be Able to Learn in 2014

Under the Affordable Care Act, starting in 2014, every drug and medical device maker that gives money to physicians has to report this spending in a federal database. Required reporting will include data on payments, ownership, investment interests, and other items of value that pharmaceutical companies give to doctors and teaching hospitals. The first public deployment of this database is scheduled for September 2014, and will include information compiled from August through December 2013. Originally authored by Senator Charles Grassley (R-Iowa), this “Sunshine Act” is designed to curb the practice of pharma companies paying or otherwise compensating physicians who prescribe medications to patients.

What Medical Facilities Are Doing to Curb Abuses

Some private practices, hospitals, and teaching facilities are taking it upon themselves to crack down on pharmaceutical payments to doctors. In Colorado, The University of Colorado and National Jewish Health have clamped down on payments since a 2011 exposé on these practices by the Denver Post. Some facilities have rejected proposed speaking contracts or required physicians to undertake speaking engagements without pay. Some hospitals analyze prescribing patterns to learn if there are differences in prescribing patterns between physicians who receive money from drug makers and those who don’t. However, in some cases, institutions appear to sidestep their own rules. One physician with National Jewish Health resigned a faculty position over paid speaking engagements, but still sees patients at National Jewish as a contracted physician.

Public distaste for the lavish conferences and other occasions bankrolled by big pharma in the past led to a decrease in those practices, but pharmaceutical companies are still cozy with a lot of US physicians. Pro Publica’s Dollars for Docs database, plus the new federal database scheduled to be deployed in 2014, are expected to put more distance between pharmaceutical companies and the physicians who prescribe their products.

Photo Credits: David Castillo Dominici /, MConnors

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