By Craig Stellpflug |
Is your doc on the Big Pharma payroll? Federal whistleblower lawsuits have charged that drug companies reward cash to doctors who dole out prescriptions for their drugs. Big Pharma companies such as Merck and Eli Lilly have disclosed $258 million in payments nationwide in 2009 and the first half of 2010. ProPublica reports $26.4 million dollars paid out to doctors in California in that same period. But these are just totals from the seven pharmaceutical companies while over 1,000 other drug, device and medical supply companies were not included in this figure.
Big Pharma companies are well known for paying kickbacks and other inducements to physicians, hospitals, and pharmacies for prescribing their drugs. Some doctors who prescribe large amounts of drugs are given gifts such as liquor, gift cards, lavish meals, paid travel, tickets to sports events, paid golf outings and gift certificates. Others receive direct cash payments of up to several hundred dollars to watch a sales representative flip through a book of promotional drug "visuals," or to watch a video on the sales representative's laptop.
Big Pharma targets high prescribing doctors for expense paid resort events called "drive-to's" and "fly-to's." Big Pharma "consultant" meetings are staged at high-end restaurants with lavish diners and sometimes lucrative "honorariums" are paid to the physicians for showing up. Big Pharma companies pay doctors thousands of dollars to give presentations about off-label use of a product or device and likewise, doctors attending these presentations are paid to listen.
A NY Times article mentions that large numbers of doctors receive payments of sometimes hundreds of thousands, even millions of dollars from drug and device companies every year in exchange for providing advice and giving lectures. All told, about a quarter of doctors take cash payments and about two-thirds of doctors routinely accept gifts of food, including lunch for staff members and dinner for themselves.
The Times reported that doctors who take money from drug makers often practice medicine differently from those who do not and are more willing to prescribe drugs in risky and unapproved ways, such as prescribing powerful antipsychotic medicines for children.
What's being done about it?
A suit filed way back in 2007 by former Bristol-Myers employees in the Superior Court of the State of California was sealed until recently when it was joined by California's insurance commissioner to sue Big Pharma giant Bristol-Myers Squibb Co. The suit accuses the company of bribing "high prescribing" physicians with trips to basketball camps, free concert tickets, autographed basketball merchandise, liquor, golf outings and other rewards to boost prescriptions. Low-prescribing doctors were told that they would not receive free samples or event invitations.
In Michigan, lawmakers and physician groups both opposed an incentive program launched by Blue Care Network, which ran a three-month campaign to pay doctors $100 for each patient who switched from a brand name drug to a generic cholesterol-lowering medication. The American Medical Association even posted a statement on its Web site that reads: "A physician accepting payment from an insurer in exchange for moving a patient from a brand name to a generic drug could potentially face both criminal and civil liability exposure under the federal antikickback statute."
Under the new health care law, the more than 1,100 drug, device and medical supply companies will have to file reports of doctor payments as of October 2011 (didn't happen yet). Of course, this will generate large amounts of new data for federal officials to inspect and a nightmare of drug company record audits to make sure the reports were accurate and complete. When it gets up and running, companies will be fined up to $10,000 for each payment they fail to report.
Is your doctor on the Big Pharma payroll? Can your doctor be trusted to not be blinded by the flash of cash?