Healthy Skepticism Library item: 15019

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Publication type: news

Johnson LA.
Drugaker Pfizer to disclose payments to doctors for consulting, clinical trial work next year
The Chicago Tribune 2009 Feb 9
http://www.chicagotribune.com/business/sns-ap-pfizer-doctor-payments,0,5350310.story

Full text:

Pfizer Inc., the world’s biggest drugmaker, said Monday it will begin disclosing all sizable payments it makes to doctors, including those who test experimental drugs in people, a first for the industry.

The disclosures would begin early next year and are planned to include all payments to medical personnel who prescribe drugs – doctors, physician’s assistants and nurse-practitioners – exceeding $500 in a year, the New York-based company told The Associated Press.

The move comes after introduction last month of legislation to require such disclosures, and revelations of astronomical payments to some doctors that were not revealed to universities and hospitals that employed them.

“It’s very important that we earn the trust of patients and the public,” Pfizer Chief Executive Jeffrey Kindler said in an interview from Chicago, where he planned to announce the new initiative at an economics conference Monday evening. “People … have come to various misapprehensions about what these payments are about.”

He said medical research requires such collaborations between industry, doctors and academia. Last year, Pfizer worked with nearly 8,000 investigators.

The initiative will also include payments to universities and research sites involved in clinical research, and will cover non-financial gifts to doctors such as meals, travel expenses, textbooks and anatomical models. It’s one of several by Pfizer in recent years to disclose more information about its operations and financial ties to politicians and outside groups.

Consumer groups, politicians and others increasingly have been criticizing industry payments to doctors who promote a particular drug brand to colleagues, provide consulting services to drugmakers or work on human tests of experimental drugs, yet don’t disclose that they are receiving tens of thousands of dollars – even millions, in rare cases – for those services.

A handful of drugmakers, including Merck & Co. and Eli Lilly & Co., have recently announced plans to disclose payments for consulting, giving speeches and the like.

Pfizer is the first company to add payments to doctors who work on clinical studies, write up reports for medical journals on them and otherwise provide behind-the-scenes support for getting an experimental drug approved by regulators.

Some industry critics – but not all – praised the move.

Sen. Charles Grassley, the ranking Republican on the Senate Finance Committee and co-sponsor of a bill introduced last month to require such disclosures by drug and medical device makers, called the Pfizer news a tribute to how far the reform movement has come.

“There’s so much public money and public trust at stake with the financial relationships between the pharmaceutical industry on one end and the practice of medicine on the other end, that the public has a right to know what those relationships are,” Grassley said in a statement. “Every step in the direction of disclosure is a step in the right direction and helps to build the case for passage of legislation to establish nationwide reporting of this kind of information.”

Grassley and Sen. Herb Kohl, D.-Wis., are jointly sponsoring the Physician Payments Sunshine Act of 2009, which would require makers of traditional pills, biologic drugs and medical devices to annually report all payments to doctors over $100 to the U.S. Department of Health and Human Services. The bill includes penalties of up to $1 million for knowingly failing to report such information.

A similar version was introduced two years ago, but never got a hearing in Congress. The two senators have since noted what they call “a groundswell of support” for such disclosures.

Dr. Sidney Wolfe, co-founder of Public Citizen Health Research Group, called it “preposterous in the context of the Neurontin scandal,” a reference to a $430 million legal settlement Pfizer paid earlier in the decade related to promotion of the epilepsy drug.

The company had been accused of illegally paying doctors to prescribe Neurontin for uses not been approved by the U.S. Food and Drug Administration, which is illegal.

“Pfizer’s “collaboration” with many physicians resulted in illegal, off-label promotion and marketing of Neurontin, sales of billions of dollars of the drug for diseases for which there was no evidence of benefit, and Pfizer’s pleading guilty to criminal charges and paying penalties of $430 million,” Wolfe said.

Another frequent industry critic, Dr. Steve Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, called it “commendable” that several pharmaceutical companies have decided to publicly reveal payments to doctors.

“I’m pleased companies are beginning to come around and see the public, the media and others have a right to see who’s receiving payments, how much and for what purposes,” Nissen said. “The more complete (the disclosures), the better.”

He said there’s now clearly a trend of this. Nissen would prefer to see Pfizer disclose payments of $100, as the Senate bill would require, but added that, “The worst abuses have involved thousands and even millions of dollars, and clearly a $500 minimum is reasonable.”

Pfizer last year became the first pharmaceutical company to begin posting on its Web site the grants and charitable contributions it makes. It also was the first company to create a Web site about drug safety that is not linked to promotion of products, http://www.pfizer.com/medicinesafety. And, like many other drugmakers, it posts results of its clinical studies online and reports on its U.S. political contributions.