Two Memphis doctors rank second and third on a national list of doctors who have taken the most money from pharmaceutical companies to give talks about their drugs to other doctors.
Wesley Neurology Clinic neurologist Stephen H. Landy ranked second on the "Dollars for Docs" list compiled by ProPublica, a nonprofit journalism organization, with $302,125 earned in 2009 and 2010 by speaking to doctor groups about drugs developed by GlaxoSmithKline, Cephalon and Merck.
UT Medical Group endocrinologist Samuel Dagogo-Jack ranked third on ProPublica's list with $257,012 in two years from GlaxoSmithKline, Eli Lilly and Merck.
The only doctor in America who out-earned Landy and Dagogo-Jack in speaker fees from drug companies was Nevada endocrinologist Firhaad Ismail, who took $303,558 from drug companies, according to ProPublica's "Top Earners" list.
Seven drug companies have begun posting what they pay to doctors for speaking and educational engagements, according to ProPublica. The organization said nearly 70 more companies have yet to report but they will have to by 2013 under a mandate in health reform legislation.
The Physician Payments Sunshine provisions in health reform won't ban gifts to doctors but will require full, public disclosure of them. Any company that sells drugs, medical devices, biologics and medical supplies covered by Medicaid, Medicare or the State Children's Health Insurance Program will have to file an annual report to the federal government listing each gift they've given to doctors.
The perception from consumer advocates is that doctors' treatment habits are influenced by gifts like free trips, meals at nice restaurants and entertainment.
"Patients deserve to know if their doctors are receiving money from drug companies," said Allan Coukell, director of the Pew Prescription Project, a consumer safety project aimed at the marketing of prescription drugs. "While many relationships between academic medicine and industry are necessary and beneficial, they create potential conflicts of interest that can influence prescribing and drive up costs."
Doctors counter that they are simply informing other doctors about new drugs that could help their patients. They say that it is then up to individual doctors to prescribe drugs to their patients.
When asked how he felt about ranking so high on ProPublica's list, Landy said, "It's kind of surprising that it would even be written about." Public perception of the practice is "very negative," he said, adding that the drugs are "good drugs and they benefit patients."
He said ProPublica's information has been taken out of context. While he has been paid for his time, travel and work by drug companies, he said he does a lot of free work in his field, like teaching at the University of Tennessee Health Science Center, editing a professional journal and publishing neurology research papers.
He said ProPublica's research makes it look like pharmaceutical companies and doctors are taking advantage of patients and that's "just totally wrong."
"These programs are not about encouraging doctors to write drugs in the wrong way but rather to write drugs in the right way," Landy said. "I don't think any physician is going to go to an educational program and start writing a drug that isn't what he or she feels is right for their patients."
Attempts to reach Dagogo-Jack for comment were unsuccessful. Media representatives at UTMG and UTHSC did not make him available for comment. A university media representative said "the university has nothing to add on this topic."
Russ Miller, senior vice president of the Tennessee Medical Association, said the group has no formal rules on pharmaceutical payments to doctors but follows the rules from the American Medical Association.
The AMA's policy on "Gifts to Physicians from Industry" says gifts serve an "important and socially beneficial function" and that companies have "long provided funds for educational seminars and conferences," though, "there has been growing concern about certain gifts from industry to physicians." The policy says gifts should benefit patients and should not be of "substantial value."
Doctors speaking at meetings or conferences can accept "reasonable honoraria" and reimbursement for "reasonable" travel, lodging and meal expenses, according to the policy. However, it also says doctors attending those meetings should not take industry money to pay for travel, lodging, personal expenses or to pay for the doctors' time.
"When physicians are compensated for speaking on behalf of a company, it's almost like they're a subcontractor," TMA's Miller said. "They are being paid for their time, travel and talent. And for the pharmaceutical company, (the doctor) is a paid testimonial. You're a walking advertisement."
According to ProPublica's "Dollars for Docs" database, the seven drug companies that have reported these figures paid $282 million in 2009 and 2010 to get doctors to speak about their drugs. Eli Lily, the maker of drugs like Cialis, Cymbalta and Prozac, spent the most with $124.7 million.
The seven pharmaceutical companies made 753 payments to Tennessee doctors in 2009 and 2010 that totaled $7.9 million. Individual payments were as low as the $18 that Knoxville doctor Nancy Schenk got from Eli Lily this year for consulting, according to the list. Nashville doctor Hal Roseman got the highest single nonresearch payment. He received $131,250 in speaker fees from GlaxoSmithKline.
Mitchell Steiner said he understands the controversy behind these payments. But as a urologist, a former UTHSC department chair and now CEO of Memphis pharmaceutical company GTx Inc., he said the arrangement has to work.
Physicians have to help develop drugs because they know what patients need, he said. Drugs would never reach patients without companies because universities can't sell them. Companies need doctors to tell other doctors about drugs because they have the clinical experience and scientific know-how to explain them and "industry can't really do that; we're stuck."
"It's like saying we want you to go fight a war but you can't have any soldiers ... because if you do, you're going to dirty them in the field, and they're going to be fighting for you, and you don't want them to do that," Steiner said. "Well, that doesn't work, does it? Doctors give (the pharmaceutical industry) information from the field, and you have to pay them for that."
-- Toby Sells: 529-2742
Tennessee's Top 10 earners
1. Stephen Landy, Memphis: $302,125
2. Samuel Dagogo-Jack, Memphis: $257,012
3. Hal Roseman, Nashville: $240, 100
4. Terri Jerkins, Nashville: $203,899
5. Jon Draud, Nashville: $200,075
6. John Fenley, Johnson City: $130,764
7. Timothy Jennings, Chattanooga: $126,522
8. Amanda Sparks-Bushnell, Nashville: $117,023
9. Rahn K. Bailey, Nashville & Franklin: $115,242
10. Asa Heflin, Nashville: $111,250
Source: ProPublica
Sunday, December 12, 2010
2 Memphis physicians top national list for speaking fees from drug companies » The Commercial Appeal
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