Double Dip: Doctors Paid to Advise, Promote Drug Companies That Fund Their Research

by Charles Ornstein and Ryann Grochowski Jones

Research has been seen as less objectionable than other forms of interactions with drug companies, but 10 percent of researchers have multiple ties among the nine companies ProPublica analyzed. That raises questions about doctors’ impartiality.

Pharmaceutical companies pay for the clinical trials that Dr. Yoav Golan conducts on antibiotics at Tufts Medical Center.

They also pay him tens of thousands of dollars a year to give speeches and advice on behalf of their drugs.

If Golan worked at some teaching hospitals, he would be barred or severely restricted from accepting both research funding and personal payments for promotional speaking or consulting from drug makers. These hospitals fear the money could influence clinical findings, or at least create the appearance of a conflict of interest.

Yet Tufts and many other academic medical centers allow doctors to accept overlapping payments — and some doctors still take them.

A ProPublica analysis shows that more than 1,300 practitioners nationwide received both research money and speaking or consulting fees from the same drug maker in 2012. All told, they received more than $90 million in research grants — plus nearly $13 million for speaking engagements and another $4 million for consulting.

Critics say doctors who conduct a clinical trial while accepting personal payments from the company sponsoring the study can feel beholden to the drug maker.

“The pharmaceutical company has a paramount stake in a favorable outcome. The [research] grant recipient has a stake in a favorable outcome and the honorarium recipient or consultant has yet another stake in the outcome,” said David Rothman, director of the Center for Medicine as a Profession at Columbia University. “It’s not only my lab. It’s my mortgage.”

ProPublica used its Dollars for Docs database, which tracks payments to practitioners by 15 drug companies, to conduct the review. Not every company discloses all types of payments — research, speaking and consulting — or distinguishes between the types. The analysis covered the nine companies that disclosed payments in this form.

Golan, an infectious disease specialist, was the only doctor who received speaking, consulting, and research payments from three companies in 2012, the most recent year for which data has been compiled. Pfizer, Merck, and Forest Labs gave Tufts $51,000 for his research that year, in addition to paying him $125,000 to speak about their drugs and $13,000 for consulting. His speaking fees ranked second nationally among all the researchers examined, and his total personal payments ranked fourth.

Golan referred questions to the public relations department at Tufts Medical Center, which said in a statement that Golan complies with its research conflict-of-interest policy and that officials keep a close watch over his work.

“Dr. Golan’s work has contributed to the development of two important antibiotics, including the first antibiotic developed in the past 25 years to treat the growing threat of deadly C. difficile,” the statement said.

Pharmaceutical companies’ payments for promotional speaking and consulting appear to have decreased in recent years, as blockbuster drugs have lost patent protection and the push for transparency has advanced. Beginning this fall, all drug companies will have to publicly disclose payments they made to doctors, under the Physician Payment Sunshine Act, part of the 2010 Affordable Care Act.

But industry-backed clinical studies, which can lead to advances in care, have largely been seen as a separate matter.

ProPublica’s is the first large-scale analysis of how frequently researchers receive additional payments from companies that fund their clinical trials. About 10 percent of researchers for the nine companies examined for this story also received money for speaking or consulting, or both.

One doctor’s conflicts: When research meets promotion

Dr. Yoav Golan, an infectious disease specialist at Tufts Medical Center, received speaking, consulting and research payments from three companies in 2012, the only physician in ProPublica’s Dollars for Docs database that met those criteria. Some ethicists question doctors’ abilities to stay impartial when receiving both research and personal payments from pharmaceutical companies.

Forest Labs Merck Pfizer Total
Research $30,360 $12,050 $9,062 $51,472
Consulting $6,050 $5,000 $2,250 $13,300
Speaking $53,300 $43,740 $27,500 + $124,540
=$137,840

Source: Company disclosures, ProPublica research. NOTE: Research payments were made to Tufts Medical Center, with Golan listed as the principal investigator.

Pfizer had the lowest rate of dual relationships among its researchers, about 7 percent; Novartis and ViiV Healthcare had the highest, at more than 15 percent.

ViiV spokesman Marc Meachem said his company focuses exclusively on HIV medications, so “the number of people with the expertise to do both the research and be expert speakers is a lot smaller.”…

more…

http://www.propublica.org/article/double-dip-doctors-paid-to-advise-promote-drug-companies-that-fund-research

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