Medications save lives and bring comfort to the sick. But they’re also a big business. The nonprofit investigative newsroom ProPublica has been pulling back the curtain on pharmaceutical giants that lavish money on physicians who promote their products.
ProPublica data guru Dan Nguyen provided California Watch a spreadsheet of payments from drug companies to California physicians.
To see if your doctor is also a drug company speaker, educator or researcher, you can scroll through the spreadsheet or query the “Dollars for Docs” database at the ProPublica website.
The data forms the basis for a series of reports by ProPublica and myriad news organizations.
We searched the data when working on a piece that looks at doctors who mix prescribing and promoting. As we explain, one U.S. senator is taking a look at prolific prescribers, and we point out who among them are also drug promoters in the Golden State.
One ProPublica report tested the theory that drug companies simply compensate physicians for educating health professionals about drugs they believe in. Reporters Charles Ornstein and Tracy Weber reported on lawsuits by former drug representatives who allege otherwise.
Here’s a bit of what they found:
– Allergan, the maker of Botox, created faux advisory boards solely “to reward hundreds of its top injectors,” federal prosecutors charged this month. More than 200 doctors, for example, were put up at an oceanfront resort in Newport Beach, Calif., in 2005 and 2006 and paid $1,500 to listen to presentations, according to their sentencing memorandum.
Allergan settled with the government for $600 million last month and pleaded guilty to a misdemeanor for misbranding Botox. Allergan said in a statement that it is “committed to conducting its business with the highest ethical standards and in compliance with all applicable laws.”
– Forest Laboratories created “preceptorship” programs in which physicians were paid up to $1,000 each to allow a sales rep to spend time observing their practice. “In reality, Forest sales representatives used the preceptorships to induce physicians to prescribe [anti-depressants] Celexa and Lexapro,” according to a 2009 complaint filed by federal attorneys in Massachusetts.
The reps filled out “return on investment” forms to justify the payments from 1999 until 2003. One rep noted that a psychiatrist’s prescription “numbers were trending up,” and “we need to keep a good thing going as long as we are still getting this kind of growth,” the complaint said.
A Forest subsidiary pleaded guilty to one felony and two misdemeanors and the company paid $313 million in criminal and civil fines. In a statement, Forest’s CEO said the firm had improved its “compliance program since the events at issue in this investigation, which occurred a number of years ago.”
Another ProPublica report, published in the San Francisco Chronicle, focused on doctors who were paid to represent drug firms, even though the state medical board found fault with their work.
The disciplined doctors only represent about 3 percent of those who accepted money from pharmaceutical firms. Still, the articles raised the question of whether drug companies are choosing the top physicians in their field to discuss their medications. Chronicle reporter Victoria Colliver noted some examples:
San Francisco psychiatrist Karin Hastik, for example, took $168,658 in speaking and consulting fees from Eli Lilly, AstraZeneca and GlaxoSmithKline since 2009.
But in May, the Medical Board of California placed Hastik on probation for negligence, prescribing drugs without prior examination, and failing to keep adequate records about a patient she had been caring for since 2000. Hastik did not return calls for comment.
Dr. Gerald Sacks, an anesthesiologist with offices in Los Angeles and Santa Monica, was California's top earner in the database, receiving $249,822 from drug companies since 2009. More than half - $150,097 - came from Pfizer.
2003, the state medical board cited Sacks, who did not return calls for comment, for failing to maintain adequate records of a patient he treated for back pain.
The first ProPublica report focused on doctors who earn $200,000 or more, including Dr. Sacks:
Another top earner, pain physician Gerald Sacks, declined several times through his receptionist to discuss his speaking fees. Since 2009, he has earned at least $249,300 from three companies.
Sacks' slides from a 2008 educational talk [PDF] and 2009 presentation before the U.S. Food and Drug Administration [PDF], describe him as the director of pain management at St. John's Health Center in Santa Monica, Calif. A hospital spokesman said Sacks has never held that title and that his pain clinic is not part of the hospital. He does have the ability to admit and treat patients at St. John's.
His private practice is busy, typically treating between 150 and 200 pain-management patients a week, he said while testifying [PDF] on behalf of Xanodyne Pharmaceuticals before the FDA panel in 2009.
Ultimately, the series pushed some drug companies to say they will be more careful in screening the physicians who represent their products.
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