Thursday, September 15, 2011

TN doctors have deep ties to drugmakers

The latest data in a ProPublica study of financial ties between doctors and big drug companies reveal deeper links involving Tennessee physicians and medical researchers than were previously known.

One Nashville psychiatrist’s take from five major drug companies for a two-year period crossed the half-million-dollar threshold, the data show.

Overall, drug companies disclosed $20.8 million in spending in Tennessee for speakers’ fees and consulting work or picking up the tab for doctors’ meals and travel costs. The total includes money that went to individual doctors and research institutions such as Vanderbilt University Medical Center and the Sarah Cannon Research Institute.

That revised total is up from $8.9 million when ProPublica last compiled drug-company disclosures in December, combing through a database of such payouts as fresh information from additional pharmaceutical companies has been reported.

Among Nashville-area physicians, psychiatrist Jon W. Draud collected the largest amount, a total of $633,181 in speaking and consulting fees, travel and meals from the first quarter of 2009 through this year’s first quarter.

Doctors, firms say patients benefit

Dr. Hal M. Roseman, a cardiologist who has collected nearly $300,000 in industry payouts over the past two years, makes no apologies for receiving fees for being a speaker at events organized by drugmakers.

His payments from the second quarter of 2009 through this year’s first quarter were $294,000. That includes money from Merck and GlaxoSmithKline.

“It has not altered my practice,” Roseman said of the financial gains, adding that sharing his knowledge with other doctors about medical issues helps patients get proper care, and it doesn’t determine which drugs he prescribes.

“The pharmaceutical industry clearly benefits by promoting their products, but in many instances it’s to the benefit of society that these educational efforts continue,” Roseman said.

That stance echoes drugmakers’ explanation of payments to doctors.

As ProPublica was preparing to release its report on Wednesday, the drug industry defended its practices as a way for doctors to stay current with information about drug performance and related risks.

Diane Bieri, executive vice president of the Pharmaceutical Research and Manufacturers of America, said in a news release:

“Interactions between biopharmaceutical research companies and healthcare professionals play a critical role in improving patient care and fostering appropriate use of medicines. …

“Through these programs, physician speakers are able to help their peers stay up-to-date with clinical data about new FDA-approved medicines, new uses of medicines, emerging risks and side effects, and more,” she said.

Bieri said the industry also supports increased transparency to reveal to consumers the business and research relationships between drugmakers and doctors.

Still, Dr. Kevin H. Beier, an emergency medicine physician with Middle Tennessee Medical Center in Murfreesboro, has concerns about doctors taking the payouts.

“Unless there’s complete separation between drug companies and physicians and hospitals, the most cost-effective and best medicine for the specific illness may not be utilized,” he said.

However, he believes only a small fraction of physicians are prescribing drugs and treatments under the direct influence of the pharmaceutical industry.

Beth Uselton, executive director of patient advocate group Tennessee Health Care Campaign, said the disclosures by the drug companies are a key step toward transparency and a more efficient, fair and cost-effective health-care system.

“Shining a light on those sorts of economic relationships tells us a lot about why the health-care system is the way it is,” she said. “In and of itself, financial ties don’t necessarily compromise physicians’ judgment, but there’s always a possibility that an economic relationship affects delivery of care to patients and the types of drugs prescribed.”