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Drug Makers Pay Doctors To Promote and Prescribe MedicationsThe Chicago Tribune reported that drug companies paid more than $25 million to Illinois doctors to promote and use drugs from the pharmaceutical companies. Nearly 40 physicians got payments and perks exceeding $100,000 between 2009 and early 2011.

Eight drug companies paid more than $220 million to doctors and promotional speakers in 2010 to promote their drugs.

Starting in 2013, all drug and medical device companies must report such information to the federal government which will make these disclosures available to the public.

The most controversial payments involve consulting arrangements and promotional speeches. Drug company officials say they are funding talks that provide much-needed medical education, led by physicians who are experts in their fields. Critics say financial relationship between doctors and drug companies can threaten patient care by influencing physicians to prescribe certain medications whether or not they are the best choice.

Until 2009, drug company payments to doctors and other health professionals were closely held as trade secrets. However, some companies have begun reporting this information in advance of the 2013 requirements and pressure from lawmakers or as a condition of settling federal whistle-blower lawsuits.

ProPublica has created a database called Dollars for Docs identifying amounts paid to doctors for promotion of drugs and medical devices. Dollars for Docs has identified more than $760 million in disclosed marketing payments from only 12 companies between 2009 and the 2nd quarter of 2011.

"[The drug company payments] make it look like physicians are not impartial or are in the service of the drug companies, and can cause patients to wonder if physicians’ recommendations for treatment are being made because it was the best option based on their clinical expertise or because they have a relationship with the company," [Hastings Center research scholar Josephine] Johnston said. "I don’t think many physicians have taken that risk (of patient distrust) as seriously as they should."

In 2009, the Chicago Tribune reported on the millions of dollars paid by foreign drug maker AstraZeneca to doctors in order to promote its anti-psychotic drug, Seroquel. AstraZeneca paid one Chicago doctor, Dr. Michael Reinstein nearly half-a-million dollars to promote Seroquel. In return, Dr. Reinstein provided AstraZeneca with a vast customer base.

Dr. Reinstein was traveling the country telling doctors that Seroquel would help patients lose weight while the FDA was warning about Seroquel’s link to weight gain and diabetes. Even Seroquel executives called Dr. Reinstein’s conclusion that patients experienced no adverse side effects "suspect" and "hard to believe". When faced with the choice of protecting patients or protecting profits, AstraZeneca and Dr. Reinstein chose profits over safety.

Johnson & Johnson’s DePuy Orthopaedics division also paid millions — more than $80 million — to surgeons to promote its artificial hip systems. The US Department of Justice brought charges against four medical device companies – including DePuy – in 2007, claiming the companies were using kickbacks to doctors in promoting their products. However, DePuy kept paying doctors:

  • $48 million to doctors in 2009
  • $33 million from January to September 2010

Some surgeons received more than $1 million in single year.

These payments create a direct conflict of interest between doctor and patient. Drug company sponsored research potentially taints results and doctors create the impression – and sometimes the actual effect – of choosing profits and drug company kickbacks over patient safety.

Read More:

[More on Dangerous Drugs]

[More on the DePuy Hip Recall]

(c) Copyright 2011 Brett A. Emison

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