Is Your Doctor Being Paid By Pharma? That Could Be Good

John LaMattina

Contributor

Most have heard about how the biopharmaceutical industry pays billions of dollars a year to doctors across the U.S. These payments have been largely undisclosed and this has led many to believe that these funds are being used for the sole purpose of influencing the prescribing practices of doctors. As of September 30th, however, this has all changed. That is because a provision of the Affordable Care Act of 2010, called the “Sunshine Act”, has now gone into effect. This law mandates that not just industry payments to doctors, but also dentists, chiropractors, podiatrists, and optometrists be disclosed. The types of payments include promotional speaking fees, meals, consulting, and research.

These payments can now be viewed by anyone on the Centers for Medicare and Medicaid Services (CMS) website: cms.gov/openpayments. But even before the website went live, debate had begun around the impact and revelations that would be had from the data. Typical was the comment from Allan Coukell, director of the Pew Prescription Project.

“The financial relationships between doctors and drug companies and medical-device companies are a source of conflicts of interest. They have the potential to influence the care that patients get and so they’re a matter of interest both to individual consumers and to policy makers”

The worry, of course, is that any form of interaction between companies and physicians “taints” the judgment of those prescribing medicines to an uninformed public. My guess is that people will be taken aback by the amount of money being paid to physicians. The Wall Street Journal reported that drug and medical-device companies paid at least $3.5 billion to U.S. physicians in just the final five months of 2013. Many will surely think that this amount of money is certainly being used to buy a lot of influence.

However, if one digs into the numbers just a little bit deeper, a different picture emerges. Companies like Pfizer PFE +0.16%, Lilly, and GlaxoSmithKlinehave been disclosing their payments to physicians on their websites for a number of years. Investigating these websites reveals that the vast bulk of these payments are being made to compensate doctors and institutions for carrying out clinical trials. In fact, Pfizer indicates that 80% of its payments to healthcare professionals in the U.S. were for such reasons. Most people don’t realize that the large and expensive trials required to demonstrate the safety and efficacy of experimental medicines are not done by pharmaceutical companies but instead are carried out in academic medical centers by physicians across the globe. These studies are arduous and highly regulated. They require long hours and detailed record keeping that must pass FDA scrutiny. This is difficult work but it is crucial in bringing new medicines to patients. Physicians and their institutions rightfully deserve to be compensated for these efforts.

The biopharmaceutical industry seeks out the best doctors to work with on these important clinical programs. After all, these trials can cost anywhere from $10 – 500 million and one can’t afford suboptimal trial design or execution. Thus, a company tries to involve the best experts for the particular disease for which the experimental medicine is intended. This serves multiple purposes. For one thing, these experts serve not only to lead the trial but also to consult on its design. Furthermore, if the trial is successful, presumably these world experts will have first-hand experience that they will then share by means of publications and presentations.

So, if you decide to go on cms.gov/openpayments and find that your doctors are being paid by the biopharmaceutical industry, don’t automatically assume that they have a tainted relationship with the industry. They may instead be leaders in their fields who are looking to find the next big breakthrough to treat cancer, depression, or heart disease.