"psychiatrists earn more money from drug makers than doctors in any other specialty ... For instance, the more psychiatrists have earned from drug makers, the more they have prescribed a new class of powerful medicines known as atypical antipsychotics to children, for whom the drugs are especially risky and mostly unapproved." - New York Times, June 27, 2007, Psychiatrists Top List in Drug Maker Gifts
The Associated Press
September 24, 2008
WASHINGTON - In an industry first, Eli Lilly and Co. says it will begin disclosing how much money it paid to individual doctors for advice, speeches and other services.
The drug company's move comes as members of Congress push a disclosure bill in an effort to prevent such payments from improperly influencing medical decisions.
Beginning next year, Eli Lilly will disclose payments of more than $500 to doctors for their roles as advisers and for speaking at educational seminars. In later years, the company will expand the types of payments disclosed to include such things as travel, entertainment and gifts.
Some have voiced concerns that doctors are influenced by these payments in their treatment decisions and that in turn can drive up medical bills. Although most physicians believe free lunches or trips have no effect on their medical judgment, research has shown that such payments can affect how people act.
"The ethical handwriting is on the wall. Disclosure is coming. States are pushing for it, and once a few states do, it's hard to imagine the federal government won't line up behind," said Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.
Eli Lilly was the first drug company to report its educational grants for medical conferences publicly. Dr. John Lechleiter, chief executive of the company, said that made good business sense for the drug industry. "We've learned that letting people see for themselves what we're doing is a good way to restore trust," he said.
In the past two years, lawmakers introduced bills that would require drug and medical device manufacturers to disclose any payments to doctors exceeding $25, but the industry chafed at the strict reporting threshold. Eli Lilly had announced earlier that it intended to comply with key aspects of the legislation once some lawmakers agreed to the higher reporting threshold of $500.
Eli Lilly's disclosure of payments to doctors will begin in the second half of 2009, for payments made in the first half of the year. The company doesn't plan to report 2008 or earlier payments, noting that the legislation before Congress did not contemplate such a look back.
Lechleiter said physicians who advise the company or speak at conferences take time away from their medical practice. That's why they need to be compensated at fair, market rates, he said.
A handful of states and the District of Columbia already have disclosure laws for payments from drug companies to doctors. Those states are Minnesota, Vermont, West Virginia and Maine. None of those states require disclosure of payments from medical device makers.
Dr. Peter Lurie, deputy director of the health research group at Public Citizen, said the state laws are not working very well. They have various exemptions and sometimes don't even disclose the information to the public, he said. Lurie was skeptical that Eli Lilly's announcement represented a step forward on the issue of more transparency in health care.
"There are dozens of pharmaceutical companies. ... Most won't follow this guideline at all, and there will be no enforcement," Lurie said. "This is Ely Lilly's attempt to forestall the federal legislation by saying we're in effect complying anyway." Public Citizen, a consumer advocacy group, also objects to the $500 threshold for reporting. Lurie said it should be much lower - $25 per gift.
"Most of what will wind up being disclosed is speaker's fees, consulting and research grants," Lurie said. "But most people want to know more than that. They want to know about meals, travel and that sort of thing. A lot of people will be cut out by the $500 annual limit."
Link to story: http://www.orlandosentinel.com/topic/ny-hsdrug245855554sep24,0,6103822.story