Most doctors aren't getting rich off speaking to other physicians about pharma products. But some are, according to a new analysis by ProPublica. In fact, some doctors are taking in so much money for their work on pharma's behalf that one wonders how they have time to actually practice medicine.
Of the hundreds of thousands of doctors in ProPublica's database of pharma payments, 21 brought in more than $500,000 from 2009 to 2012. One took in more than $1 million. They may have made even more, because a dozen major drugmakers don't yet disclose their financial relationships with doctors.
"How do these folks have time to do their real jobs if they're speaking so much?" Susan Chimonas of the Center on Medicine as a Profession at Columbia University told ProPublica.
Indeed, one of the 22 highest-paid doctors--Vladimir Maletic, who made $527,850 on teaching and speaking for drugmakers from 2009 to 2012--now figures he may need to cut back. Asked by ProPublica how often he speaks, Maletic said, "[B]ased on the numbers that you have quoted, it may possibly be too often."
Some pharma companies have been cutting back on their payments to doctors. GlaxoSmithKline's ($GSK) speaking budget dropped to $7.6 million for the first three quarters of 2012, compared with $24.1 million in 2011 and $52.8 million in 2010. That's in part because the company has fewer new drugs to promote, a spokeswoman said. AstraZeneca's ($AZN) payments have also dropped, to $12.2 million for the first three quarters of 2012 from $17.6 million in 2011 and $31.6 million in 2010.
Others have stepped up their efforts. Forest Laboratories, for instance, which has lost a good-sized chunk of sales to generic rivals for its antidepressant Lexapro, spent $31 million during the first 9 months of 2012. Doctors were paid to speak about its newer antidepressant Viibryd, as well as the high blood pressure drug Bystolic and COPD drug Daliresp.
Once again, psychiatrists are among the most active speakers on Big Pharma's behalf. Half of those 22 highest-paid doctors are psychiatrists, including Maletic and the top-paid Jon W. Draud.
Ironically enough, some high-profile scandals involving psychiatrists helped prompt Congress to mandate disclosure of pharma payments. And off-label marketing settlements involving antipsychotics, such as Eli Lilly's ($LLY) Zyprexa, detailed all sorts of payments to psychiatrists, including speaking fees, freebies, and more. In fact, several off-label settlements required drugmakers to disclose their financial relationships with doctors.
The disclosures are starting to cut both ways, ProPublica notes. Doctors who are speaking for multiple drugmakers--Draud collected speaking fees from at least 5 companies--may get some pushback from their clients. Pharma companies are reportedly using their competitors' payment disclosures against "doctors who are greedy," Chimonas said.
Want to find out how much your company is paying out to doctors? And which doctors it's paying most? ProPublica's database can be searched here.
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