I don’t have any problem with well respected and informed doctors making presentations and informing their colleagues about drugs. It is quite appropriate to have doctors help in this role. But you can’t do both jobs at once and hope to maintain the perception of being unbiased. I have a problem in depending upon a personal doctor to give me objective independent advice only to find out that he has not disclosed to me that he is accepting truckloads of cash to take on such a role for a drug company. In truth, the reason he probably does not inform his patients is that they would object, just like I do.
Thanks for that perspective. It is important to note that these payments in general are not illegal although I consider them unethical. Our doctors are still not required to disclose the payments they receive, it is only a fortunate turn of events that seven companies have been required to release this information.
You know, one of those “perks” is free samples to give to their patients. I happen to know a couple of diabetics who might not be alive without those free samples.
My doctor is on there as taking $2,500 from eli lilly who makes humalog. And I am on Novolog, so I don’t really think there is much to get worried about. He is a good doctor.
I think you said it here. Disclosure is very important.
Did you ever check out this link, by the way?
Of course I did. I know exactly what companies make the drugs I am on and what I have requested and what my doctor has pushed. I can’t pinpoint any specific instance of a conflict of interest, but I am concerned.
Okay, Okay… I was just trying to be helpful… Cus it talks about tactful ways on how to bring up talking to doctors re: their getting $ from pharmaceutical companies, and if they are getting any from med companies not listed there, etc… 
You are helpful. I already have enough trouble with my doctor-patient relationship andI consider the broaching of this topic an “exit interview.” I’ll probably request that his staff provide me with his “response” to the question first and see what he has prepared.
Actually, unless the payment falls squarely into a safe harbor under the Federal law, they are questionable.
Both the PhRMA Code (the trade assocaition for pharmaceutical industry) and AdvaMed (the trade association for the device industry) have addresdsed the issues of consulting arrangements, KOLs, etc. Generally, the relationship is fine as long as it is contractual, for specific services, and payment is equal to fair market value for such services in an arm’s length transaction. It can be done - in fact, it can all be done-- if it is done within the framework set by the law.
Speaking fees are ok if they are pursuant to a contract, for actual services performed, and at the fair market value for those services.
It is all fine and dandy for these guidelines to be established so that the pharmaceutical and device industries are not violated by legal or ethical breaches of conduct, but this does little to address the patient. I’m very happy my doctor did not get an outright “bribe” from GSK and instead probably actually spoke, but that does little to comfort me with the knowledge that I was specifically mislead about who exactly he is working for.
Since you are in the middle of this you know exactly what I am talking about. The government should be protecting patients, but as usual is acting “weakly.”
Thought this article might be of interest. http://www.ahcancal.org/facility_operations/ComplianceProgram/Pages/RiskPoliciesProc.aspx
Well, my endo is back in the news (http://pubrecord.org/nation/8485/dollars-docs-whos-pharmas/) as one of the “most successful” dinner speakers, one of 43 earning more than $200,000 since 2009. Below they even showed his picture:
And here what happened when he was contacted:
Some among the top-paid doctors declined to discuss their pharma relationships, citing packed schedules.
"Because of the busy clinical practice, family illness and staffing change and travel, I am quite overwhelmed right now,” wrote Virginia endocrinologist **** **** who earned at least $229,200 from four companies.
I am so mad I could spit. I just have to accept that I wasted a year and get a new doctor. There doesn't seem any point in even seeing him again.
bsc… I think you’re a smart guy… The fact is that doctor NEVER listened to you. He doesn’t listen to your concerns, he doesn’t do appropriate testing, and he won’t give you insulin. You ought to have left him a LONG time ago… regardless of his pedigree. What if he never had done any of those things? Would that make it acceptable to put up with him anyway? I think not. You deserve much better.
Thanks. I had perhaps been fooling myself that I would actually be able to talk with him at my December appointment. But as I perused his grades over the last year at www.vitals.com I see that my experience matches others and attempts to “fix” this are useless. You are right, time to move on.
Packed schedule–whatever. Yea, traveling to his next speaking engagement. Much easier to make a career out of pharm relationships than deal with patients.
I’d have dumped him ages ago. Move on to an endo with less “star” quality.
I think he should be consulting you :
He might learn something!
And in a final nail in the coffin, I have discovered the full list of companies that have paid honoraria to my former endo as of last December. Isn’t requiring full disclosure a b**ch:
Abbott Laboratories, Auxilium Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, GlaxoSmithKline plc., Novartis AG, Novo Nordisk A/S, Pfizer Inc., F. Hoffmann-La Roche Ltd., sanofi-aventis U.S. LLC., and Takeda Pharmaceutical Company Limited.
Now, as I go through the list of the medications that my endo ran me through, I find that every drug he ran me through is listed as having paid him an honoraria. Lilly has Byetta, Novo Nordisk has Victoza and Takeda has Actos as well as being the primary supplier of my metformin. Every single medication he put me on was from a company that paid him an honoraria.
I somehow feel better about my decision.
ps. And just so we are clear, companies that paid only fees for services or travel expenses are not in the above list.