Report says pharmas pay quacks to hawk drugs

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A big investigative piece by journalistic non-profit ProPublica broke in multiple outlets today, with most leading on an assertion that pharmas are paying sketchy docs to hawk their products.

ProPublica's “Dollars for Docs” project, produced in conjunction with NPR, PBS's Nightly Business Report, the Chicago Tribune, Boston Globe and Consumer Reports, corralled 2009 and 2010 company data from seven pharmas on payments to physicians into a searchable database and added information on sanctions against some doctors.

ProPublica looked at more than a quarter billion dollars paid to 17,700 healthcare professionals by the seven companies in 2009 and 2010 for the report. In reviewing physician licensing records for the 15 most populous states plus three others, reporters found that “more than 250 speakers” had been sanctioned. Forty had received FDA warnings for research misconduct, lost hospital privileges or been convicted of crimes. Another 20 had had two or more malpractice judgments or settlements.

“Their misconduct included inappropriately prescribing drugs, providing poor care or having sex with patients,” wrote the report's authors, Pulitzer Prize winners Charles Ornstein and Tracy Weber. “Some of the doctors even lost their licenses.”

The report also features a sidebar on whistleblower lawsuits against pharmas for allegedly marketing products illegally. An embeddable app lets readers search for payments by their doctor's name and state.

"This is the best organized slam on medical marketing I have seen in my 20 years following this business," said Coalition for Healthcare Communication executive director (and former professor of journalistic ethics) John Kamp. "It is not responsible journalism. It is orchestrated defamation."

A note by ProPublica managing editor Stephen Engelberg calls it “part of a broader effort to expand the possibilities of collaborative journalism,” and invites readers to take part by looking up their physician and sharing their personal experiences – if, for example, they felt pushed to take a branded drug.

George Dunston, whose firm Obsidian HDS tracks HCP payments for hospitals and medical schools, praised the ProPublica database, saying it "could be an effective tool for allowing consumers to search data on their own personal physicians."

Dunston has noticed some trends of his own, namely the increasing number of physicians collecting such payments—his database includes more than 30,000—as well as the emergence of a roughly defined set of physicians getting paid in 2010 vs. 2009. "We're noticing the same numbers and in many cases the same physicians," he told MM&M. "It says to me that there is probably a consistent population of physicians on a year-by-year basis that are engaged in speaking and consulting, which is not surprising because these are 'leading physicians' and thought leaders don't change overnight."

“By 2013, all drug companies will be required to publicly disclose payments to doctors,” writes Engelberg, referring to requirements under the sunshine provisions of the Affordable Care Act. “But we saw no reason for readers to wait three years for information that is already beginning to become available to anyone who could penetrate and scrape data from pharma's labyrinthine websites.” Many pharmas have, over the past few years, begun posting data on payments to physicians publicly -- though, as ProPublica noted, the data available varies widely by company.

ProPublica launched in 2007, funded largely by the Sandler Foundation and established to do the sort of expensive investigative journalism that downsized news outlets increasingly can't afford to do – and give most of it away for free to news outlets. Pew Charitable Trusts, which has promoted conflict of interest policies at medical institutions and pushed for passage of the Physician Payments Sunshine Act, donated $1 million to the group in June.
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