By Pat Anson, Editor
Have you ever wondered why your doctor recommended a particular drug or treatment, when cheaper and better alternatives were available?
A treasure trove of data released by the Centers for Medicare & Medicaid Services (CMS) may help you get some answers. It shows that pharmaceutical and medical device companies paid nearly $6.5 billion to doctors and research hospitals in 2014, the first full year the companies were required to disclose the payments under the Affordable Care Act (ACA).
You can see what your doctor was paid, if anything, by clicking here to search the CMS "Open Payments" database.
“Consumer access to information is a key component of delivery system reform and making the healthcare system perform better,” said acting CMS Administrator Andy Slavitt. “This is part of our larger effort to open up the health care system to consumers by providing more information to help in their decision making.”
About half of the $6.5 billion was for research, such as clinical trials to find new treatments for cancer, diabetes, Alzheimer’s and other debilitating diseases.
Over $400 million went to doctors to reimburse them for meals, beverages, lodging and travels costs.
The Wall Street Journal dug into the data further and found some questionable items, including a trip to a Cayman Islands resort, tickets to Alcatraz, and a $65 airport massage.
But it’s the sheer scale of the payouts – over 11 million payments to over 600,000 physicians – that has critics wondering if prescribing practices and treatment decisions are being unduly influenced by money and gifts. The average physician received about $3,644 last year.
“No pharma companies spend this kind of money in a disinterested way,” Jason Dana, a professor at Yale School of Management told Bloomberg Business. “We have to know where the money is going to really understand the problem, to develop policy.”
Dana says doctors can be influenced by free meals and perks, even if they’re not consciously aware of it.
“If we have a financial incentive to believe something or conclude something, we kind of trick ourselves into thinking it’s true. And we’re not always aware we’re doing it,” he said.
Purdue Pharma, the maker of OxyContin and several other painkillers, reported $5.8 million in research payments and $6.1 million in general payments to doctors -- modest amounts compared to what others companies paid.
Pfizer, the maker of Lyrica, reported at least $234 million in research payments and $53.3 million in general payments.
Eli Lilly, the maker of Cymbalta, paid over $137 million for research and $8.7 million in general payments.
The American Medical Association disputes a lot of this data, saying the “vast majority” was never vetted by physicians.
"The complicated and cumbersome process for physicians to register to review their data and seek correction of any inaccuracies continues to hinder their participation in the validation process," the AMA said in a statement.
Curious about your doctor? I was about our longtime family physician and searched his name in the CMS database.
I found nothing scandalous or suspicious, but there was a surprising amount of detail. I learned he received $707.59 in “food and beverage” and “informational meal” payments last year from AstraZeneca, Forest Pharmaceuticals, Eli Lilly, Pfizer and several other companies. What was on the menu is anyone’s guess, but what they talked about is duly noted.
For example, the arthritis drug Celebrex was discussed at a $12.60 meal that Pfizer paid for. And Eli Lilly bought a $11.74 meal for my doctor so he could learn more about the erectile dysfunction drug Cialis.
The most expensive item was a meal for $127.80 paid for by Shionogi, a Japanese drug company. The topic was Osphena, a post-menopausal drug for women to help them have pain free sex -- a discussion apparently reserved for only the finest of restaurants.