Pharma companies spend billions of dollars a year on marketing to doctors. The good news? You can now find out if your doctor is getting paid, and by whom.

Is Your Doctor Getting Paid by a Pharmaceutical Company?

In Fertility by The Modern Belly10 Comments

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Two weeks ago, on his HBO show ‘Last Week Tonight’, John Oliver had a fascinating segment about the cozy – maybe too cozy – relationship between doctors and Pharmaceutical companies (the full video is at the end of this post). Now, the fact that big pharma spends big money on incentivizing doctors to promote their products is old news – we all see the promotional pens and notepads, and if we’re lucky, we may also be getting some free samples once in a while. What surprised me was the scale at which this happens. As I learned from the show, pharma companies spent $24 billion in 2012 alone on marketing to doctors. In fact, most of them spend more on marketing than they do on research.

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.

The Open Payments website gives the public access to a database of payments from pharma companies to doctors.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.

When pharma companies market to our doctors, this is what they pay for. Now there's a simple and transparent way to find out if your doctor is getting paid.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.

Pharma companies spend a lot of money marketing fertility drugs to reproductive endocrinologists. Now there's a simple and transparent way to find out if your doctor is getting paid.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?

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Comments

  1. I love John Oliver and his show. We checked out our RE after the show and didn’t see anyinformation which surprised us. Maybe she has kickbacks before or after the reporting period?

    Here from ICLW.

    1. Author

      Yes, it currently covers just 5 months, so I’m pretty sure that when it gets updated, new names will suddenly show up there. I plan to check back in June.

  2. Thanks, this is so interesting! I was a contractor on-site at a major pharma company for a few years. I was using promotional pens for YEARS after that. If only it was limited to pens, right?

    1. Author

      You know what’s crazy? A few years ago, the Pharma industry agreed to voluntarily stop distributing pens, mugs, and other promotional gifts. But free lunches are still ok – maybe because patients can’t see them?

  3. Wow, thanks for this. I knew about the issue but not the scale- pretty stunning. I appreciate your taking the time to explain it in detail.

  4. I saw this too and didn’t actually go search but I will now! I had an earache that felt like a knife in my ear and the DR (who was not someone I knew, just someone available for ear stabbing immediate appointments) prescribed some nonsense that had a $150 copay! It was basically numbing drops and did nothing to the actual condition. I don’t think I need to even search her and thank goodness for nice pharmacy counter guy.

    1. Author

      I had a really similar experience with a dermatologist once – when I got to his office, they gave me a bag full of tiny samples, and lo and behold, he ended up prescribing one of them, with a crazy high co-pay. Most doctors are not like that, but I’m really glad there’s now a way to be more aware of those who are.

  5. Your posts with in-depth info and analysis is always intriguing! My husband & I follow John Oliver’s episodes and this segment from season 2 was interesting indeed. I had worked for a major pharma company in their IT department for 5+ yrs, so I was aware of all these payments, gifts, dining and conferences. But like you mentioned, the scale at which this was done was surprising me as well. My RE’s name didn’t come up in the search, but two of my OB-GYN’s did. One is just a few hundreds and the other a few thousands of dollars! But not any drugs from them were prescribed for me too, though. Sigh!

    1. Author

      Wow, it must be interesting to see this from the other side… I definitely plan to look up my doctors again when the full two years of data are uploaded later this year. It just helps us make more informed decisions about our healthcare providers.

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