Pharmaceutical industry spends millions on doctors

Clark County doctors got $190,000 over 18 months

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Payment data

The Columbian gathered information detailing pharmaceutical company payments to medical professionals from a database prepared by the nonprofit ProPublica, which reported that 14 Clark County-based doctors received more than $190,000 in 2009 and the first half of 2010. It's likely that the practice continued beyond June 30, the most recent date data was available. It's also possible more doctors received these payments because ProPublica only collected data from seven drug companies that disclosed payments. In Vancouver, more than 70 percent of the payments -- about $138,000 -- came from Eli Lilly.

Check your doctor

To see if your doctor has taken payments from pharmaceutical companies included in investigative nonprofit ProPublica's database, visit its website.

Pharmaceutical companies are paying millions of dollars to psychiatrists, physicians and other medical professionals each year — including at least 14 providers from Clark County.

These local doctors received more than $190,000 from drug manufacturers in 2009 and the first half of 2010. They joined more than 17,000 doctors nationwide who received a combined total of $257.8 million from pharmaceutical firms paying for educational programs, speaking engagements, consulting and other services.

Payment data

The Columbian gathered information detailing pharmaceutical company payments to medical professionals from a database prepared by the nonprofit ProPublica, which reported that 14 Clark County-based doctors received more than $190,000 in 2009 and the first half of 2010. It’s likely that the practice continued beyond June 30, the most recent date data was available. It’s also possible more doctors received these payments because ProPublica only collected data from seven drug companies that disclosed payments. In Vancouver, more than 70 percent of the payments — about $138,000 — came from Eli Lilly.

Check your doctor

To see if your doctor has taken payments from pharmaceutical companies included in investigative nonprofit ProPublica’s database, visit its website.

Taking money from drug companies is a common practice — but it’s drawing scrutiny from people who worry that doctors will prescribe pills made by the businesses that sign their checks, even when another treatment may be superior. Supporters of these payments argue that their medical decisions aren’t influenced by payments, which predominantly fund education programs for other doctors. They say strict precautions are taken to present only scientific data and that the programs’ benefits outweigh potential conflicts.

As pharmaceutical companies start to release information about their payments to doctors ahead of an upcoming federal requirement that this information be made public, doctors will increasingly face questions about the payments they accept.

Funding education

Data analyzed by The Columbian showed that five Clark County doctors each received more than $12,000. Jeffrey J. Hansen, a psychiatrist, received $107,302, about five times more than was given to anyone else over the same time period, according to publicly available reports.

“I don’t believe it influences my prescribing practices because I work with a number of companies,” Hansen said. “I want to make sure that no matter who’s sponsoring my speaking the message is the same.”

Most of the money Hansen received came from Eli Lilly. Hansen said he spoke to health care providers — mostly physicians — about a disease state associated with major depressive episodes. He talked about new research on neuroimagery and genetics and didn’t discuss Eli Lilly’s product for the disease.

“There’s actually no medication-specific information provided,” Hansen said.

Hansen also received $8,000 from AstraZeneca in the first half of 2010. For AstraZeneca, Hansen said, he spoke on new indications for a medication the company uses to treat major depressive disorders.

Hansen didn’t speak to patients or other lay people.

Payments are not incentives to promote specific treatments, he said.

“When I partner with a pharmaceutical company they actually cover the cost of my overhead in presenting this data,” he said. “I enjoy the process of speaking and talking about psychiatry and I do think it improves quality of care for patients.”

The talks, he said, help other practitioners — such as pediatricians, internists and primary care physicians — learn more about psychiatry and how to better recognize mental health concerns that come up in their own practices.

“It’s truly an educational series just based on education related to illness,” Hansen said.

Questioning ethics

It’s unlikely that doctors who receive payments from pharmaceutical companies believe they’re selling out, said Howard Brody, the director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston and author of “Hooked: Ethics, the Medical Profession and the Pharmaceutical Industry.”

Brody believes that there is a conflict of interest inherent in these payments — but he doesn’t condemn physicians for accepting the money. The current medical establishment encourages ties between medical professionals and pharmaceutical companies.

For example, small hospitals and medical groups often welcome doctors who offer free training. These health care groups may not be able to afford the payments that physicians have come to expect, but they need to bring in training because doctors are required to earn community medical education credits.

Despite his concerns, Brody said the public shouldn’t be angry with doctors who accept these payments.

He estimated that 94 percent of medical professionals have some sort of financial tie to the pharmaceutical industry.

“If what the public is looking for is a pure physician, they have a long way to go to find it,” he said. “I would personally prefer there were a lot more.”

Local rules

Clark County’s two hospitals have specific policies limiting the doctors they employ from receiving payments from pharmaceutical companies.

Southwest Washington Medical Center prohibits pharmaceutical representatives from holding raffles, drawings or “other activities that lead to personal gifts for providers or employees.” The policy also says doctors — most of whom are not employees of the hospital but partner with its Southwest Medical Group — “should not directly solicit or receive personal gifts from pharmaceutical companies.”

Southwest does not prohibit doctors from receiving payment for work that they do with pharmaceutical companies, however.

Legacy Health System’s policies say payments, reimbursements or subsidies should not be accepted to cover travel or to compensate for time spent away from practice. Limited exceptions apply for doctors who incur out-of-pocket expenses, and only then under certain conditions.

Legacy directly employs about 900 people in Clark County, 30 to 40 of whom are doctors, spokesman Brian Willoughby said. Legacy’s administrative policy — which is updated every three years, most recently in January — prevents doctors with whom it contracts from accepting cash or cash equivalents. It also prohibits doctors from accepting gifts totaling more than $75 per year from any given vendor. Willoughby said the policy covers foundation board members and members of Legacy’s management team, not just its doctors.

“We hire people with integrity,” Willoughby said.