Drugmakers aren't spending as much on speaking fees these days. Some companies--namely Pfizer ($PFE) and Eli Lilly ($LLY)--have slashed physician payments by more than half.
That could smell like victory to the politicians, professional associations and other advocates who pushed for payment disclosure. Indeed, some doctors have said they're wary of taking pharma payments now, for fear that patients might misinterpret them.
But are companies similarly wary, now that they are forced to show the world how much they're paying doctors to speak on behalf of their products? "It's very hard to pinpoint exactly why that's happening," Sunshine Act lawyer Scott Liebman told ProPublica, which has been collecting and analyzing pharma's doctor-payment data. "I think there's a lot of potential answers to that."
The companies put forth a few of them. With blockbuster primary-care drugs now off patent, their makers no longer need doctors to help spread the word about them. Specialty drugs, pharma's new red meat, don't need to be promoted to a vast army of primary-care doctors. They're prescribed mostly by specialists. And frankly, some companies don't have many new products for doctors to talk about.
Consider this: Johnson & Johnson ($JNJ) has scored a series of R&D successes over the last couple of years, with new products such as the prostate cancer treatment Zytiga and the anticoagulant drug Xarelto. Its speaking fees for doctors grew by 17% in 2012, ProPublica notes.
Forest Laboratories ($FRX) posted $40 million in doctor payments in 2012; with its longtime best-seller Lexapro off patent, the company has been beating the streets to promote newer drugs, including its antidepressant Viibryd and the blood-pressure drug Bystolic, for which it acquired exclusive rights in 2012.
But Lilly has seen its development efforts stumble, and its payments dropped by 55%. Merck ($MRK) has suffered its own setbacks, and its doctor fees fell by 28%. "The value of educational programs tends to be higher when we're launching a new medicine or we have new clinical data [or a] new indication," Lilly spokesman Scott MacGregor told ProPublica.
Government prosecutors initially strong-armed companies into publicizing their payments to doctors, from speaking fees to research grants to consulting payments. Eli Lilly and Merck & Co. were among the first to agree to post their physician payments online as part of legal settlements.
Meanwhile, a couple of high-profile scandals at leading medical schools, plus a rash of marketing settlements with a who's who list of drugmakers, helped transparency aficionados galvanize support for across-the-board disclosure. That's why the Physician Payments Sunshine Act is now taking effect in the U.S.
GlaxoSmithKline's ($GSK) speaking fees plummeted by 62% in 2012, partly for a different reason: The company decided to limit payments to doctors. It's part of an overhauled sales model at the company, which paid $3 billion to settle Justice Department marketing allegations. In December, the company said it would take its reformed sales-rep compensation plans worldwide, and push to end speaking fees to doctors completely.
- read the ProPublica coverage
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