by Joseph Mercola
April 13, 2016
If your doctor receives money or gifts from a drug company, be it
payment for a lecture or a free meal, does it influence the
medications he or she in turn prescribes?
This represents the burning question in
an industry saturated with
pharmaceutical company involvement.
ProPublica analysis revealed nearly nine in 10 cardiologists, and
seven in 10 internists and family practitioners, included in their
study received payments from drug or device companies in 2014.
But the analysis didn't stop there.
It also looked into whether or not such payments were associated
with prescribing practices, and here's where things got interesting.
Received Drug-Company Money Prescribed More Brand-Name Drugs
ProPublica analyzed the prescribing habits of doctors who wrote at
least 1,000 prescriptions in the 'Medicare Part D' drug program.
The doctors belonged to five common
specialties: psychiatry, cardiovascular disease, family medicine,
internal medicine and ophthalmology.
Not only was the receipt of drug-company money associated with a
higher percentage of brand-name drug prescriptions, but the
prescriptions rose with the amount of money received. 2
The analysis included promotional speaking, consulting, business
travel, meals, royalties and gifts as forms of drug company
payments. Those who received more than $5,000 from industry in 2014
prescribed the most brand-name drugs.
According to the analysis:
"In all cases, the group receiving
larger payments had a higher brand-name prescribing rate on
Additionally, the type of payment made a difference:
those who received meals
alone from companies had a higher rate of brand-name
prescribing than physicians who received no payments
those who received speaking
payments had a higher rate than those who received other
types of payments."
Drug-Company Payments 'Thinly Veiled Kickbacks?'
Dr. Aaron Kesselheim, an associate professor of Medicine at
Harvard Medical School, told The Atlantic regarding the featured
"It again confirms the prevailing
wisdom… that there is a relationship between payments and
brand-name prescribing… This feeds into the ongoing
conversation about the propriety of these sorts of
Hopefully we're getting past the point where people will say,
'Oh, there's no evidence that these relationships change
physicians' prescribing practices'."
Indeed, this is far from the first time
that such payments have been linked to prescribing practices.
A 2010 study published in the Archives of Internal Medicine also
found that nearly 84 percent of physicians surveyed reported some
type of relationship with industry during the previous year, and
those with such a relationship were more likely to prescribe a
brand-name drug even when a generic alternative was available.
The finding isn't only relevant for patients, who may be paying more
unnecessarily for brand-name drugs, but also for taxpayers who spend
billions each year subsidizing Medicare Part D.
At least 1 in 4 U.S. prescriptions are
paid for by Medicare.
Meanwhile, it's worth repeating that the reason drug companies pay
doctors and aggressively promote certain medications is not to
benefit patients; it's to benefit their bottom line.
often a fine line between legitimate payments and illegal kickbacks.
ProPublica noted: 5
" … [F]ederal whistle-blower
lawsuits against several pharmaceutical companies have alleged
that payments are little more than thinly veiled kickbacks,
which are illegal.
Companies have paid billions of dollars to
settle the cases."
Heavily Promote 'Me-Too Drugs' to Doctors
Past research by ProPublica revealed the drugs most aggressively
promoted to physicians, and they're not medical breakthroughs or
even, generally, top sellers.
Instead, they tend to be drugs that are newer to the market,
sometimes underperforming and often face competition from other
older, readily available drugs.
Dubbed "me-too" drugs, their makers may claim they carry fewer side
effects, work faster or have other advantages over existing drugs on
the market. 6
Another ProPublica study revealed that top prescribers of some of
the most heavily marketed drugs tended to receive promotional
speaking payments from the drugs' makers. 7
Still Trust Your Doctor If He or She Accepts Drug Company Payments?
In 2012, research showed that accepting gifts from the
pharmaceutical industry does have implications for the
doctor-patient relationship, and,
"doing so can undermine trust and
affect patients' intent to adhere to medical recommendations."
Not surprisingly, most people surveyed
in one study said they would have less trust in their physician if
they learned he or she accepted gifts worth more than $100 from the
pharmaceutical industry, or went on industry-sponsored trips or
One-quarter even said they would be less likely to take a prescribed
"if their physician had recently
accepted a gift in return for listening to a pharmaceutical
representative's presentation about that drug." 9
It's no wonder that most physicians
would rather their patients not know about any kickbacks they've
received from the drug industry.
But now that this has become public
information, it may very well prompt some physicians to cut their
ties to the industry.
Unfortunately, quite often - definitely too frequently for comfort -
treatment recommendations are biased in favor of a specific drug
simply because people making the decisions stand to profit from it.
If you find your doctor is receiving large amounts of money from
industry, you may want to find another doctor or get a second
opinion. At the very least, if you have concerns you might open a
conversation about whether the drugs you've been prescribed are the
best choices for you.
Whatever your health problem might be, I strongly recommend digging
below the surface using all the resources available to you,
...to determine what medical treatment
or advice will be best for you.
You Can Find
Out If Your Doctor Accepts Drug-Company Money (and How Much)
ProPublica's "Dollar for Docs" Website, which you can
use to find out if your doctor accepts money from the drug industry,
more than 1,500 companies have made payments to nearly 686,000
doctors, totaling close to $3.5 billion. 10
You can also find out if your doctor receives payments from Big
Pharma by visiting
OpenPaymentsData.CMS.gov. This site
has tallied nearly $6.5 billion in payments since 2013. 11
It hasn't always been possible to find
out what gifts your own doctor might be accepting.
Physician Payments Sunshine Act,
which is part of the Affordable Care Act, went into effect in 2013.
For the first time, the Act requires drug and medical device makers
to collect and disclose any payments of more than $10 made to
physicians and teaching hospitals.
The Centers for Medicare and Medicaid Services (CMS) is in
charge of implementing the Sunshine Act, which it has done via its
Open Payments Program.
You can easily search the site to find
out what (if any) payments your doctor has received, along with the
nature of the payments.