A dozen pharmaceutical companies have paid doctors in the US nearly $150m so far this year, according to industry data that suggests an increase in these controversial marketing and support practices .
The figures highlight the extent of entertainment, travel, consulting, education and research support to doctors – payments that the industry says are ethical and enhance health outcomes, but which critics believe can influence prescribing practices.
While some large companies, such as Sanofi, have so far not released any data, those that did collectively reported payments of $437m to 262,000 doctors last year. But data mainly from the first quarter of this year shows $148m has been given to 165,000 doctors so far, including $48m from Eli Lilly and $42m from Pfizer.
This analysis by the Financial Times, prepared in conjunction with PharmaShine, a data provider, comes at a time of intensifying scrutiny of – and prosecutions concerning – pharmaceutical groups’ marketing practices. Government agencies are finalising guidelines that will make the publication of industry support compulsory by 2013 as part of US healthcare reforms.
Publication is designed to allow regulators, medical institutions and patients to better scrutinise doctors’ links with companies, but the extent of current disclosures and the way they are presented varies widely – making comparisons and analysis difficult.
Allan Coukell, head of the Pew Prescription Project, a drug safety watchdog, said: “We need the medical community to work with the industry on research, but the marketing model is problematic. The first step is transparency and we are not even there yet.”
Eli Lilly is one of a few companies to include funding for medical research at doctors’ institutes in its figures. Others list only support directly to individual doctors.
A spokesman said: “Lilly is committed to ensuring that our relationships with healthcare providers are conducted in a manner that complies with applicable legal and ethical standards. Our collaboration with healthcare providers is essential to our ability to provide innovative medicines, improve health education, better understand patients’ needs and improve individual patient outcomes.”
Among the individual doctors receiving the highest level of support was Zale Bernstein, an associate professor from the Roswell Park Cancer Institute in Buffalo, New York, who received $234,000 in 2010 from Cephalon, Eli Lilly and Pfizer. He has received more than $57,000 already this year.
Dr Bernstein, who did not respond to repeated requests to comment, received most of his money in speaker fees as part of extensive industry-supported medical education programmes targeting other doctors.
Although the vast majority of physicians received far smaller sums – often limited to a small gift or a sandwich lunch of a few dollars – some studies have suggested even such very modest support can affect prescribing practices.
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