Government to make pharmaceutical payments to doctors public
Federal officials will soon require pharmaceutical companies to publicly disclose any and all payments made to doctors, claiming some of those relationships are compromising clinical integrity and patient care as well as leading to increased health care costs. More specifically, officials believe plenty of patients are not being prescribed the least expensive and most effective medication.
The data will be included in a massive database that can be accessed by the public in September of 2014.
“Every time you turn around they have a new advertisement, and it’s try this, try that,” said Pam Ullrich, an Indianapolis resident who said, while she can turn off the television to avoid the prescription medication advertisements, she has real concerns about the relationships between her son’s doctors and the pharmaceutical companies behind the medications.
“I think a lot of times, they’re trying to sell more product than do good,” said Brian Donaldson, another Indianapolis resident.
An American Medical Association study revealed 83.8 percent of all doctors surveyed reported some type of relationship with pharmaceutical companies like Indianapolis-based Eli Lilly.
“The relationships are necessary. They are professional. They are all above board,” said Liz O’Farrell, Eli Lilly Senior Vice President and Controller.
Eli Lilly has created its own database with some information about its financial exchanges with doctors ahead of the new federal law. Included in the database is $156.2 million spent on a variety of investments including research and educational programs. The research portion itself was $131.1 million for that period, or 84 percent of the total reported.
An Eli Lilly spokesperson also made the following statement:
“When selecting faculty, Lilly chooses leading clinicians who have expertise to educate about disease states, evaluate the benefits and risks of available treatment options, and educate health care providers and patients about those options.”
Dr. Fred Lane, a colon and rectal surgeon, pocketed at least $140,000 between 2009 and 2011 by speaking for Glaxo Smith Kline, according to another online database created by Pro Publica, a nonprofit investigative news group. The organization has broken down about $760 million in payments.
“If they pay my airfare, if I go out of state, that all appears too. It’s just more intrusion,” said Dr. Lane.
He claimed making this kind of information public is a bit much, and Dr. Chris Bojrab, a psychiatrist and President of Indiana Health Group in Carmel, said he agrees to an extent. Dr. Bojrab made more than $70,000 in the beginning of 2011 working for Eli Lilly, Pfizer and Cephalon. While the doctor did not publicize the amount of money he was collecting, he did make public a long list of relationships with pharmaceutical companies on his website.
“There are physicians who write far more prescriptions for some of the medications that I speak for than I do that are not speakers,” said Dr. Bojrab.
The Pro Publica database makes it easy to do a quick search and discover a list of Central Indiana doctors who have been raking in some extra money not seeing patients.
Dr. Dmitry Arbuck, a psychiatrict and pain management specialist with Meridian Health Group in Carmel, made nearly $170,000 over a year and a half period. None of that money was for research, which is where Eli Lilly’s staff claims is their biggest area of investment.
“We think that these relationships are important. You cannot advance medicine. You cannot improve patients’ lives without involving physicians in all aspects,” said O’Farrell.
Regardless, the relationships are about to become much more transparent thanks to the federal database that will be created with every pharmaceutical companies’ most recent records. It is a part of President Obama’s healthcare reforms. The database will include payments and reimbursements for research, speaking and consulting fees, food entertainment and travel.
Dr. Peter Schwartz, who is also an Indiana University Medical School professor, focuses on ethical issues related to medicine. He said the pharmaceutical company deals with doctors have created a big problem.
“All of those interactions are very good at getting doctors to do treatments which are an improvement over what’s been available before, but they’re also very good at getting doctors to do things which are not an improvement, maybe even worse or dangerous, and are definitely more expensive,” said Dr Schwartz, Indiana University Center for Bioethics.
A doctor who spoke with Fox59 mentioned an increase in his earning between 15 to 20 percent for consulting or speaking at pharmaceutical events all over the country. All three doctors interviewed also said they only speak for medications that they believe in.
“The drug works. It does what it says it does. So, for me, to go out and talk about it, I don’t have any trouble justifying that,” said Dr. Lane.
“It should have its place. It should not be abused, but not having it would be a loss as well,” said Dr. Arbuck.
“Could consulting be a legitimate thing to do? Sure. Is this money dirty? It’s not dirty money. It’s just money that comes with an impact,” said Schwartz.
Consumers who spoke with Fox59 said the relationships make them feel as if they are stuck in the middle, forced to use their best judgment as they wait for the more detailed information about the doctor-pharmaceutical company relationships.
“They’re not just peddling clothes or jewelry or money. They are peddling medicines,” said Jamie Valentin, another Indianapolis resident.
“It is concerning and alarming because you want a ground base, and sometimes, you’re not sure you’re getting that,” said Ullrich.
The pharmaceutical companies will be required to turn over the data to the government by March of next year. The data that will be released in September of next year will include payments made from August to December of this year.
Advice for consumers can be found at the Prob Publica website.