I have to say, there are times I just don’t want to hear any more alarming news. But recently I stumbled upon a disturbing database of payments made by drug and medical device manufacturers to physicians. It can be horrifying to imagine that your doctor or surgeon is getting huge amounts of money from drug companies or device makers, for any reason. Now imagine that the payments were hundreds of thousands of dollars, or millions. It just doesn’t pass the smell test. Think about it: if a surgeon gets $250,000.00 per year from a medical device manufacturer, do you think the surgeon is likely going to “choose” to implant devices made by the fee-paying medical device manufacturer?
ProPublica is the nonprofit organization who maintains the database. Recently nonprofit organization updated its database of doctors across the country who were paid by medical device manufacturers or drug makers in 2015. ProPublica also compiled statistics on the amount of money drug companies spent promoting certain prescription medications and medical devices. The numbers are staggering. Let’s take a look at a few of the prescription medications on ProPublica’s list that I’ve written about on this site:
Janssen Pharmaceuticals paid $28.4 million dollars to physicians in 2015 relating to the promotion of the drug Xarelto. I’ve written about Xarelto on this site, which you can check out here. These general payments to physicians included promotional speaking fees, consulting fees, meals and travel expenses, even gifts. These fees paid did not include payments for research. According to ProPublica, physicians who receive payments directly from drug manufacturers are more likely to prescribe those specific brand-name drugs than generic equivalent drugs.
Studies have shown that Xarelto, while more convenient to take than warfarin, can cause uncontrollable internal bleeding.
Eliquis is blood thinning drug similar to Xarelto and Pradaxa. I wrote about Eliquis here. In 2015, Bristol-Myers Squibb Company paid $18.8 million to physicians relating to the sale and/or promotion of Eliquis. In a recent study, Eliquis was shown to cause uncontrollable internal bleeding in patients, but not as frequently as Xarelto.
Janssen Pharmaceuticals paid $20.9 million in payments to doctors promoting the diabetes drug Invokana. Invokana has been reported to cause serious side effects, such as kidney failure, stroke, and heart attacks. A multidistrict litigation site for persons injured by Invokana is currently active in federal court in New Jersey.
AbbieVie, Inc. manufactures and sells Androgel, a testosterone drug. In 2015 AbbieVie paid $15.3 million to doctors to promote the drug. The FDA has approved testosterone products for men who “who lack or have low testosterone levels in conjunction with an associated medical condition.” Examples of an “associated medical condition” include failure of the testicles to produce testosterone because of reasons such as genetic problems or chemotherapy. But in recent years men have taken testosterone for more generalized symptoms of aging, such as reduced energy and a lower sex drive. Many doctors discourage testosterone replacement therapy, and reports show testosterone use can cause serious injuries.
More broadly, ProPublica reports that companies make approximately $2,000,000,000.00 (yes, that’s two billion) in payments to 618,000 doctors each year. These payments must be viewed for what they must be: attempts to increase sales of prescription medications and medical devices.
Sunshine Remains the Best Antiseptic
So what does all this mean? The ProPublica database should be troubling to any person who expects neutral and unbiased medical advice from his or her doctor. The data certainly does not prove that your specific doctor is giving you bad or even biased medical advice, but large cash payments made to doctors in exchange for promoting any drug is problematic at best and harmful at worst. The database provides a wealth of information on doctors in the United States who received money from manufacturers. ProPublica asserts that doctors who receive payments from the medical industry “tend to prescribe more brand-name drugs than those who don’t.”
No matter how you come down on this issue, ProPublica ought to be commended for shedding light on these payments. If all the payments are legitimate, and our nation of physicians remain neutral an unbiased in their treatment of patients, then great. But the database alone creates a needed conversation about aggressive promotion of prescription drugs, and the need for constant vigilance against unchecked greed in the pharmaceutical industry.
Feel free to click over to the ProPublica site and check on your own doctors here. If they make the list, ask them about the payments they received from drug companies. You have a right to know.
Physician Payments Sunshine Act
ProPublica obtained this data as part of the required disclosures under the Physician Payments Sunshine Act, part of the Affordable Care Act (or “Obamacare”). A bill last year attempted to weaken the Sunshine Act’s disclosure requirements, but the bill did not become law. That’s a good thing. The public needs this information.
ProPublica is an independent news organization that “produces investigative journalism in the public interest.” ProPublica’s stated goal is to produce journalism that “shines a light on exploitation of the weak by the strong and on the failures of those with power to vindicate the trust placed in them.”