Share this Post
These relationships between doctors and big pharma have always existed in the shadows, until the federal government added much needed transparency by launching the Open Payments website, which gives the public access to a database of payments from pharma companies to doctors. Right now, the website is far from perfect – it only details transactions that happened in the period of August-December 2013 and the data is still messy. The data will improve over time, especially when the full data sets for 2013 and 2014 get uploaded to the website, supposedly by June 2015. Even in its current form, it already provides extremely valuable insights into the way that the doctor-big pharma ecosystem operates.
We trust our doctors to make the right treatment decisions based on their experience and our unique situation, but what if their judgment is clouded by financial incentives from pharma companies that don’t necessarily have our best interest in mind? If my doctors are being wined and dined by a certain drug manufacturer, or if a pharma company is paying them to speak at conferences in exotic locations, I want to know about it. I won’t necessarily switch doctors or make a fuss about it (although I might…), but at least I’ll know to ask the right questions and make sure that the drugs prescribed to me are really the best fit.
One of the best things about the Open Payments website is that it allows you to search for your doctors and see whether they got paid in the August-December 2013 time period. After John Oliver’s show ended, the first thing I did was check the website, and I was relieved to find out that my RE hasn’t received any payments, and my OB/GYN was only taken out to lunch twice. I did discover that my former RE got paid thousands of dollars by a big fertility drug manufacturer. He never prescribed that manufacturer’s drug to me, but it still made me feel a little uneasy.
Being a geek, I took things a step further, downloaded the data for all the reproductive endocrinologists in the database and started analyzing it. All in all, RE doctors got paid $1 million in total during the five months covered in the database. A third of this money was royalties to one doctor for a medical device he developed. I have no problem with doctors being rewarded for advancing the medical field, so I excluded these royalties from my analysis. This still leaves us with $685,179 that went to RE doctors – what were they being paid for? Most commonly, the doctors were compensated for promotional speaking in conferences and events, with travel and lodging all covered, of course. According to John Oliver, these speaking engagements can be a bit shady, as they are sometimes scripted for the doctors. Other big expenses included consulting fees and food and beverage, as the pharma representatives often treat the doctors to lunch.
So who’s paying all this money, you might ask? Well, it turns out that the biggest spender actually had nothing to do with fertility. It was a Japanese company called Shionogi, paying $236,000 to doctors to help promote Osphena, a drug some called the “female Viagra” for post-menopausal women. The other big spenders are more familiar names for those in the infertility world. EMD Serono, manufacturer of Gonal-F, led the pack, paying doctors close to $95,000 for consulting and food. Its competitor Merck, Sharp & Dohme, manufacturer of Follistim and NuvaRing, spent $78,000 on speakers and their travel arrangements. Ferring Pharmaceuticals with its Menopur, and Actavis Pharma with Crinone, were close behind, each spending approximately $70,000. Overall, those of us being treated for infertility are fortunate in the sense that we do not need to worry too much that the drugs and treatments we are being prescribed are influenced by outside considerations. These are all well-known, established drugs, and I trust that our doctors are prescribing them because they work, not because someone incentivized them to. The money being spent to promote them is nowhere near the millions pharma companies spent during the same time period on diabetes, anti-clotting and schizophrenia drugs, some of them with scary side effects. This does not mean we shouldn’t be alert. If we find out that our doctors are getting money or perks from drug manufacturers, I think our responsibility to ourselves is to talk to them about it. Yes, it would probably be awkward and uncomfortable, but I think it would help us feel confident that we’re truly getting the best treatment plan, tailored to our needs.
Did your doctor’s name pop up in the Open Payments database search?
Share this Post