As part of lawsuit settlements, seven of the larger pharmaceutical companies have made public the payments that they made to doctors. They did not make these payments easily accessible, but now this information is readily available to search thanks to ProPublica. Jenny Ruhl just talked about this in her post Database Reveals Drug Company Payments to Doctors . You can search for your doctor at ProPublica by entering the search in at the right.
Well I found my doctor and I am disgusted. Almost as much as a "Poop Transplant". My doctor collected $140,000 in 2009 and another $89,000 in 2010. The listing only included Lilly, Cephalon, AstraZeneca, GlaxoSmithKline, Johnson&Johnson, Merck and Pfizer. It did not include any payments from NovoNordisk who makes the Victoza I now take at his recommendation, which by the way costs me $200/month and that is my co-pay.
OMG. I almost want to throw up my POOP TRANSPLANT. I am unhappy about this. I want my doctor to work in my best interests and I feel violated.
Did you look up your doctor? What do you think about this!
Wow. I looked up all my Docs and the wife / kids. Didnt find one of them. Im pleased with that.
If the Dr. would have taken cuts, I would most likely can them provided there is another in my area. If not just take the advise with a grain of salt and call the Ins, co to see if there is a cheaper med alternative. Then ask the Dr what the poop the difference in between this $200 med and the cheap on the Ins. co recommended is.
“It did not include any payments from NovoNordisk who makes the Victoza I now take at his recommendation, which by the way costs me $200/month and that is my co-pay” – if he isn’t taking money from NovoNordisk there’s no conflict in him prescribing the medication for you. If he had taken $180,000 from Novo and put all of his patients on it, there would be cause for concern. Granted, it’s slimy what’s going on, but if he’s not benefitting from Novo’s largesse, you’ve missed the point of the disclosure.
If the fact that your doctor takes money from big Pharma offends you, get a new doctor. As it is, nothing so far indicates that he has prescribed Victoza for you because NovoNordisk paid him to. Nonetheless, if your confidence is shaken - change doctors. Or ask him about it.
If it were my doctor, I’d like to know what he has said about the drugs made by the companies that have paid him and - most importantly - whether anything he’s said about the drugs is untrue. If Big Pharma is paying him to tell the truth - what’s the big deal?
I am not surprised or offended that Big Pharma throws its money around or that doctor’s take it. These facts, by themselves, do not make me suspect the motives of every doctor who takes the money.
Not all bad doctors take money from Big Pharma and not all doctors that take money from Big Pharma are bad.
Your doctor is either a straight shooter or he’s not. You either trust him or you don’t.
If you don’t trust him, for whatever reason - change doctors.
I think what bsc meant is that the only 7 companies disclosing that they paid doctors are the ones listed above, and there is no way of knowing that he actually took monies from NovoNordisk, because that is not one of the companies disclosing information… This does not mean in and of itself that he did not take money from Novo. Only that there is no proof.
Well, NovoNordisk did not report payments, so I don’t know if he accepted any payments from them. I can’t really say whether these was an actual conflict. However the real problem is the perception of a conflict, that is a huge amount of money and I just don’t know whether I can trust him to make recommendations without undue influence.
Ask you doctor what the nature of his business relationship with Novo is. If he doesn’t answer in a straightforward manner, you need a new doctor.
Are you benefiting from the Victoza? Your insurance seems to be quite stingy. $200 for a co-payment seems evil. That is steep. It’s easy enough to determine the efficacy of the drug you’re interested in.
Can your doctor request that the Victoza be put on your insurance’s formulary? Many times they will add a drug with a showing of medical necessity. It sure doesn’t hurt to ask.
Does the financial disclosure differentiate between consulting/honorarium fees and payment for clinical trials? There is a difference in those two payments. Consulting fees/honorarium are usually provided by pharma/biotech for a doctor who is considered a “KOL” or key opinion leader. These are the doctors that the other doctors listen to.
If your doctor does clinical research in his/her office and offers for you to participate in clinical studies every now and then, the payment is for services rendered - payment for study visits, data collection and reporting. If your doctor is very good at clinical research and is a high enroller, it is very easy to reach these kinds of financial numbers.
I work in the industry and I think that it is extremely important not to vilify doctors who are performing critical research for the disease. I don’t have a lot of respect for KOLs, though. Vilify away!
My doctor is not a clinician involved in trials, he is a respected leader in his profession (endo). He was a member of the task force that put together the AACE guidelines (http://www.aace.com/pub/pdf/guidelines/DMGuidelines2007.pdf) and presumably all this money came from those sorts of speaking fees. These fees are not for clinical research. And I just feel a little poopy.
Your questions are all quite pointed and valid. I am on three medications. Medications work for a couple of weeks and stop. I have been requesting tests to obtain a proper diagnosis with little success. I have been requesting insulin, also with no success. All I have gotten over the last 18 months is a procession of drug changes all eventually failing, and the same story, my diabetes is getting worse, that is why. I already had doubts, but now it is more.
The other real complaint is my endo’s relentless obsession with cholesterol. I’ve already noted to him that I have a “fatal” allergy to statins, but every visit we just argue about my cholesterol and the need to statinate. He ordered a cholesterol test last time which I failed to filter, causing me undue insurance filings and I still may have to pay an extra $200 for the d*mn test.
It is not the Victoza, but the whole picture. I probably do need a new doctor.
In all honesty bsc, if my retinopathist were on there I wouldnt care. I know they push things like Avastin and some drugs, but also I know hes kept me going strong for 10 years now. I trust him and I think thats the bigger issue here for you.
So far youve said you argue, have your medication requests denied, are put through expenses you dont feel are justified, and seem to feel the Dr. addresses his issues more than yours. This is just the icing on the cake. I think youve built your case and its time to start looking for an endo more suited to your needs. Remember, we retain their consultation, if we dont like their service we can always head to a different outfit.
Interesting side note, more malpractice suites come from a person feeling a lack of respect from a Dr. than any thing else.
Well it looks like I’m going to have a dissenting opinion here on this issue. Somebody has to present new medications to other doctors and nurses or patients and I would much rather it be a physician who works in the field rather than the drug reps or someone who isn’t an endocrinologist in the case of new diabetes drugs. And that’s especially true if that particular physician happened to participate in the clinical trials and has some first hand experience with the drug. I don’t have a problem with the docs being compensated for their time doing this. Any conferences I’ve attended the past couple of years all of the speakers have disclosed any financial information like this at the beginning of their talk. (With all the different nursing jobs I’ve had over the years I’ve attended a variety of conferences like these in several fields. I also try to attend diabetes related conferences/presentations when I can.)
Regarding the scripting. The speakers are limited to the research coming out of the clinical trials and what the FDA has approved in terms of indications for the drug. I do know they have to stick to this agenda in terms of information that the speaker volunteers. However they (the doctors) are totally free to answer questions or speak about off label use if asked. And most presentations I’ve attended questions are asked beyond what the drug companies have scripted.
When you’re shopping for a new car do you believe everything the car salesman says? We all know that’s a spiel so you take what they say with a grain of salt. You honestly don’t think physicians don’t do the same thing with drug reps?
I also know that my dr has gone to bat for me with the company reps when I’ve had trouble with poor customer service or product. (I’m talking pumping and meters here so may be different than drugs.)
And lastly I think the biggest influence on physician prescribing practices is more likely to be insurance formularies. That’s what my doc grumbles about the most is having to prescribe what he thinks is a less effective alternative because of the formulary or because I can’t afford a tier 3 drug. I’ve also seen my doc be very generous with samples if money is tight or someone is in the donut hole. They also really make an effort to keep their office stocked with as many prescription discount cards as they can too. They’re not doing that for the drug reps that’s to help the patients.
You raised a topic “near and dear” to my heart. I am an attorney working in the medical device and pharma industry. Fortunately, both federal and state governments are aware of this and are responding. Both Massachusetts and Vermont have enacted sunshine laws that require disclosure of anything of value given to health care providers (money, gifts, entertainment, etc.). Similar requirements were attached to the recently passed Federal health care act. But before that law passed, the provision was hacked at so that it now only sapplies to amounts given to university hospitals and government hospitals. But it doesn’t go into effect until a couple years down the road. There is also existing health care law – the Federal False Claims Act and the Anti-kickback statute. Both laws are focused on payments (again anything of value) that would result in fraudulent reimbursement from Medicare or Medicaid. The impact of these acts is generally, that the improper inducement of sales of pharmaceuticals and medical devices is subject to both substantial criminal and civil penalty. The Department of Justice has been cracking down on violations of this law. In the past it has been mostly with sanctions. But the DOJ is now recognizing that sanctions do not deter big companies that can afford those sanctions - so we should begin to see more of these violators thrown in jail. The sunshine laws are intended to do just what they did for you – inform patients of the behavior of their providers so they can elect providers accordingly. President Obama is much to credit for this outing of dubious conduct in the industry. He talks often about the need to attack health care fraud. So, while these practices in our health care system are heinous, the fact that patients are learning about the problem is a reason to have hope that change is in the works.
