Drug company cash flows to Utah doctors

Pharmaceutical firms have paid millions of dollars to Utah doctors and other health care professionals for speaking fees, consulting, research, travel and meals, a major database project shows.

In a new update to its ongoing Dollars for Docs project, the non-profit news agency ProPublica reports at least $7.5 million has been paid to Utah recipients by 12 big drug companies over the past two years. Data was compiled from the websites of companies that have begun disclosing such information, mostly due to lawsuit settlements. More companies, representing about 60 percent of the United States pharmaceutical market, still are keeping their payments secret.

This searchable database allows you to look up your doctors to see whether they’ve taken any money from drug companies. Searches can be filtered by reason for payment (speaking, consulting, etc.), city, drug company, payment totals, and so on. Here’s the starting Utah page if you want to try.

I called up data on three specialists I’ve seen over the years. Two were paid for “combined” services plus meals. A third raked in $4,500 for speaking.

Knowing that the doctor you’re depending on for unbiased advice about a medication may be padding his or her income with checks from the manufacturer has to give you pause. Even a free rubber-chicken dinner looks bad. Just the appearance of monetary benefit for a doctor raises an ethical flag.

Is that doctor going to be more inclined to push that drug? The money talks, in my mind. One of the doctors whose data I checked told me once that he got into medicine because it allows him “to be compassionate.” It also gives him a good living, which is fine. But I’ll be skeptical of claims to purity if my doctor has any paid relationships with drug firms.

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19 Responses to Drug company cash flows to Utah doctors

  1. Bob Becker says:

    We’ve learned to talk to pharmacists. It was a pharmacist who alerted The Geezer [my mom, now 93] that there was a low-cost alternative to a very expensive med she was on. She raised it with her specialist, and he changed the prescription. Savings well over a hundred a month. On another occasion, pharmacist alerted me that the pharmacy was selling a medicine I was getting via my insurance coverage for less than the co pay I was paying . It turned out to be less expensive for me to simply order the med and to keep my insurance out of it.

    [Disclaimer: I am not now, nor have I ever been, nor is any member of my family, a pharmacist.]

    Pays to talk to pharmacists.

    • efialtis says:

      But Bob, I don’t see that as being the same thing that Mr. Shenefelt is saying above.
      It is smart to check with the doctor or pharmacist about generic alternatives, or similar meds in the same class or family… and we should always ask about side effects.

      After reading Mr. Shenefelt’s article, I would definitely ask my doctor about any med he prescribes, especially if I haven’t heard of it before… but his prescribing it doesn’t mean it isn’t necessary, or that it isn’t the better drug.
      Many new drugs have fewer side effects. Clarinex v. Claritin, for instance… there are many new drugs for mental illness that are replacing older drugs, and these newer drugs have fewer of the undesirable side effects. But if my doctor prescribes it, does that mean he is “on the take” or that he is “prescribing what he feels is the best med for the ailment”?

      I understand this is the issue brought up by Mr. Shenefelt, but his blog post seems more accusatory… so I guess I have lots of questions:
      Does having a doctor consult, and get paid for it, make him less competent? Wouldn’t it be wise to have doctors consult with pharmaceutical companies? Should they be required to consult for free?
      Does having a doctor get paid to give a “well informed talk or presentation” and get paid for it, create some kind of ethical problem?
      Asking a doctor to find patients who might benefit from a drug, and then trying that drug… is that really wrong?

      Yes, I agree that “keyholing” someone into a drug is bad… but is that what doctors are doing? And are they being paid for putting patients’ lives in harms way?

      • Steven Brown says:

        efialtis,

        You make an interesting point here. Ethically doctors cannot engage in transactions or behaviors that are for gain that conflicts with the best interests of his or her clients. I recently left a medical facility that was selling me depakote, claiming that it was based on a low income scale. They sold it to me for $76. After I transferred my records to the other medical facility, I was told the price of the same prescription is at a cost of forty dollars without the low income scale. Go figure.

        In addition to this, the recent medical facility had me taking blood tests for my liver and depakote four times a year. The other said that it does not require that frequent a blood run. The former is federally funded. The latter is a private facility.

        Some medical organizations serve the client and some are self-serving, as I shared here. I do not mention names because that would generate a conflict of interest and media controversy.

  2. Mark Shenefelt says:

    Superb point, Bob. I was picking up a prescription recently and the pharmacist said kind of excitedly, “Hey, that just went generic!” He moved fast to get me the cheaper med. Pharmacists are some of my favorite people (same disclaimer – no pill-pusher relatives).

    However, the pharmacists usually can’t protect you from a unique, expensive drug that a doctor might prescribe. In those cases you still must trust the doctor to a) steer you to the right med and 2) be unbiased about any competitor meds. I’m cynical enough to think a doctor who’s getting cash from big pharma might put me on one unique and expensive drug made by his sugar daddy when a competitor unique and expensive drug might be a viable or even better alternative.

    • Bob Becker says:

      Not disagreeing. [Checked my dr. Not on the freebies list. Thanks for posting access link. ]

      I’ve had a long-time family doctor say to me “there are two prescription drugs for this. Really not much difference between them besides price. The newer one is more expensive. Which would you prefer [grinning]?” And it was a dr. who told me about pill splitters, and that sometimes prescribing a larger dosage pill and splitting each pill [taking half each time] would be significantly cheaper than prescribing the same medicine in a smaller dose the prescription for which would have to be filled more often.

      Been lucky I guess.

  3. Howard Ratcliffe says:

    Avastin was approved as a cancer treatment; Avastin eye injections used for Macular Degeneration given at the Moran Eye Center will set you back about $5000; since most of the people getting these are on Medicare; taxpayers pick up the tab for 80% of this. Go to a private doctor’s office and get the same injection and it will set you back $75 plus whatever fee for the injection the doctor charges.
    How’s that for Medicare abuse?

  4. Pingback: Drug company cash flows to Utah doctors – StandardNet (blog) | emedicalnews.net

  5. Pingback: Drug company cash flows to Utah doctors – StandardNet (blog) | ehealthjournal.net

  6. Howard Ratcliffe says:

    Bob, Did you get the link to the water test used at the Salem Witch Trials? Apparently they teach that in Mass. Cotton Mather was quite a character eh?

  7. Bob Becker says:

    There are a lot of websites passing on the \water test\ stories in re: salem trials. Some speak as well of the convicted being burned at the stake. None were.

    The death penalty for witchcraft in Mass Bay was carried out by hanging. All those convicted at Salem were hanged except one man who refused to enter a plea, and was pressed to death under stones. No burning at the stake. No water test.

    A good good general book on the Salem incident is Chadwick Hansen, Witchcraft at Salem. A good one on witchcraft charges and trials in Puritan New England outside of the Salem incident is John Demos’s Entertaining Satan. Hansen is a much better read.

  8. Bob Becker says:

    Got me wondering now. Is the rewards system set up by Big Pharma [speaking fees and other $ rewards to GPs and specialists] designed to get them to prescribe the companies’ wares, or is it designed to reward them for having already prescribed a certain number of products — i.e. does it operate like Mary Kay, with salespersons being rewarded for having moved product, not paid in advance in hopes of encouraging them to move product.

    I don’t know. Just wondering.

    But a system of unofficial kickbacks operates in other areas as well. I got to know some book travelers selling textbooks to schools over the years [the real money is not in college texts; it's in getting your books adopted by public schools.] They tell tales…. Like \film money.\ If Middle School X agreed to adopt your science text book series or math series or social studies series, you agreed to supply money [ hundreds of dollars fifteen years ago] in \film money.\ I.e. money to permit the school to buy supplemental instructional material like films. Sometimes the money doesn’t go to buying films. There is no accounting, or there used not to be, once it was paid after the texts were adopted.

    From college travelers I’ve heard tales of departments [not in Utah] which adopted survey texts by department — all classes use same book. Those are really rich adoptions for publishers. In one school it was understood that the entire department would be treated to dinner — and we’re not talking Dennys here — prior to adoption. No dinner, no sale.

    And sometimes to get individual professors to adopt a particular text, they’ll offer to include five or so extra copies [not marked \review copy\] for you, knowing full well you can trot over to the bookstore and sell those new copies to the books store for at least half the face price [say for a history text, you could get 25 or 30 bucks apiece these day.] I’ve been offered the \extra free unmarked copies\ several times when I was teaching, and invited to lunch or dinner to \discuss\ an adoption many times. [I declined them all. Most professors I knew did. But not all. ]

    So while the drug sweeteners are especially heinous since they involve peoples health, the general practice of… well, let’s call it \soft bribery\… is I think fairly widespread in the business world. And of course the political world — over 100 lobbyist subsidized meals and parties for Utah legislators during the last session.

    • Howard Ratcliffe says:

      css.southbridge.k12.ma.us/…/cms/…/The%20Salem%20Witch%20Trials.pdf This is the link to Mass school teaching on Salem Witch Trials; the water test is on pg 7. Do you think Moran Eye Center Doctors get a kick back from Roche on Avastan Eye injections for $5000 versus about $500 elsewhere? Did FDA Commissioner Arthur Hull Hayes get a kick back for legalizing Aspartame in Diet Coke in 1981 when Don Rumsfeld was Chairman of GD Searle Corp? Several hundred billion dollars/year is a lot of money to legalize something that fattens pigs and turns to formaldehyde in a person’s digestive tract eh? Dang, where did DOD Chief Don Rumsfeld and his Comptroller Rabbi Dov Zakheim put that missing $2.3 Trillion on 9/11/2001?

  9. Pingback: How To Find Out If Your Doctor And Drugmakers Are In A Relationship – NPR (blog) | ehealthjournal.net

  10. Pingback: How To Find Out If Your Doctor And Drugmakers Are In A Relationship – NPR (blog) | emedicalnews.net

  11. Dovie says:

    I am a pharmacist. The biggest rip-off is in payments for drug studies – we have all these small company funded studies that “prove” superiority of the new & expensive. The only way to disprove that is for the govt to fund a big, independent study. Drs get paid big bucks and they do not have to disclose any of it.

    The rules are changing though. They are going to have to (at least) start telling their institutions what they make. But not the public.

  12. kent coleman says:

    A year ago i was sitting in my doctor’s office and in walked a pharmaceutical saleswoman she walked up to the receptionest and asked her how many for lunch today and how many for the cruise next month .

    I could not believe what i was hearing .

    The receptionist answered four for lunch and two for the cruise.

    When the saleswoman left ,i asked the receptionist what company did the saleswoman work for and how long has this been going on ?

    She kind of got defensive and would not tell me.

    • Howard Ratcliffe says:

      It’s why Medicare part D prescription drug benefits are $7.5Trillion in the hole. Just how Rick Perry gets away forcing Merck Gardisil Vaccines on 12 yr old girls with his Merck VP lobbyist advising him is simply criminal.

  13. Wow, it’s so generous of you to post this — thank you!

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