Pharma shells out $2B-plus to doctors—again—with Allergan and Celgene in the lead

It’s been a few years now since the U.S. government opened up shop with its Open Payments database, a collection of drug and device makers’ payments to healthcare providers. The data-collection process itself—indeed, the very fact of it—triggered all sorts of complaint, denial and nitpicking.

But now, it’s part of the annual cycle. The Centers for Medicare and Medicaid Services unveiled the 2016 numbers Friday, right on schedule.

And despite some early predictions that transparency would change everything—doctors would start turning away speaking fees and drugmakers back off the free meals and dinner—the numbers have remained remarkably consistent.

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Pharma hasn’t stopped spending. General payments, which include meals, speaking fees, consulting and the like, came in at $2.68 billion in 2014.

2015: $2.68 billion.

2016: $2.8 billion.

Doctors haven’t stopped participating. The number of physicians—who are, of course, the primary target for pharma’s one-on-one marketing—who collected nonresearch money amounted to 625,000 in 2014.

2015: 632,000.

2016: 631,000.

Free food, travel and lodging, specifically, came in at $430 million, compared with $470 million in 2015.

What do all these dollar figures mean? They show who’s promoting which drugs to which doctors. Sometimes they can show what those payments yield. Researchers and journalists have mashed the numbers up with other data, and some have found associations between the size of payments and physician script numbers. Last year, a JAMA study—disputed by some in biopharma—found an association between the number of free meals and the number of prescriptions for brands promoted at those meals.

All told, healthcare providers’ financial ties to drug and device companies came in at almost $8.2 billion for 2016, including research funding, royalties and licensing, free meals, speaking fees, consulting payments and investment interests physicians hold in healthcare businesses. Research amounted to more than half that amount, leaving ownership and investment interests to make up the remaining $1.02 billion.

With 11 million records in this year’s database, there’s plenty to sift. A cursory look puts Allergan at the top of the Big Pharma heap with $66.4 million in general payments, with Sanofi (including Genzyme, $58.4 million), Celgene ($54.6 million), Valeant (including its Salix subsidiary, $53.1 million) and Biogen ($50 million) rounding out the top five.

Those aren’t final totals, because the companies reported payments through multiple subsidiaries, too; Pfizer, for instance, had 14 company affiliates disclosing their own payments. But we’ll have those totals, and more, as our data-crunchers put those 11 million records to work.

Details on pharma’s financial ties with doctors were first disclosed piecemeal, as part of marketing settlements with the U.S. justice department. Eli Lilly, GlaxoSmithKline, AstraZeneca and Merck & Co. were among them. The data-collection went wide—and became centralized—with the Physician Payment Sunshine Act, part of the Affordable Care Act. The Open Payments database is the first to cover all U.S. drug and device companies.

Editor's note: This story was updated with new payment totals and companies.