Posts Tagged ‘database’

Can Prozac Cause Kids to Kill? A Canadian Judge Has Ruled it Can

Wednesday, December 7th, 2011

Note from CCHR:

(see videos at the bottom of this post from film maker Michael Moore and Fox National News reporter Douglas Kennedy)

It is well documented that psychiatric drugs, particularly antidepressants, can cause a host of violent side effects including mania, psychosis, aggression, violence and in the case of the antidepressant Effexor, homicidal ideation.   As far back as 1991, CCHR helped organize dozens of individuals and experts testifying before the US FDA that people with no prior history of violence (or suicide) became homicidal and suicidal under the influence of antidepressants (see CCHR’s exclusive footage of the 1991 hearings here).  It would take the FDA another 13 years to admit antidepressants could cause suicide and black box warnings were finally issued in 2004.  However, despite all the documented violence-inducing side effects of these drugs, the FDA has never issued black box warnings on antidepressants causing violence or homicide despite the fact that at least 11 recent school shootings were committed by kids documented to be on or in withdrawal from psychiatric drugs (see Fox News special report on school shootings here).   Therefore, the case cited below, where a Canadian judge ruled that a teenage boy murdered his friend due to being on the antidepressant Prozac, and the fact that the case will not be appealed, is a major turning point in exposing the violence inducing effects of antidepressant drugs.  

National Post
By Tom Blackwell
December 7, 2011

JB Reed/Bloomberg News

A Winnipeg judge’s ruling that a teenage boy murdered his friend because of the effects of Prozac will not be appealed, confirming an apparent North American first and reviving debate around the widespread prescription of anti-depressants to young people.

Justice Robert Heinrichs concluded the 15-year-old boy was under the influence of the medication when he thrust a nine-inch kitchen knife into the chest of Seth Ottenbreit, a close friend.

Although the killer pleaded guilty to second-degree murder, the judge cited the drug’s alleged side effects as a reason not to raise the case to adult court, and to mete out a sentence last month of just 10 months – on top of two years already spent in jail.

A spokeswoman for the Manitoba Justice Department said this week prosecutors have decided not to appeal the provincial-court decisions, which were earlier met with outrage from Mr. Ottenbreit’s family and friends.

Both the boy’s lawyer and the psychiatrist who testified on his behalf say it is the first time a criminal-court judge in North America has made such a finding.

Prozac is meant to curb the effects of depression, but Justice Heinrich concluded it set off a steady deterioration in the young murderer’s behaviour.

“He had become irritable, restless, agitated, aggressive and unclear in his thinking,” the judge said. “It was while in that state he overreacted in an impulsive, explosive and violent way. Now that his body and mind are free and clear of any effects of Prozac, he is simply not the same youth in behaviour or character.”

Yet the empirical underpinning of his conclusion, and the pros and cons of young people taking Prozac and other “selective serotonin reuptake inhibitor (SSRI)” anti-depressants, seem less clear-cut.

Justice Heinrichs relied largely on the expert testimony of Dr. Peter Breggin, a controversial American physician known for his outspoken opposition to the use of virtually any psychiatric drug. Some other experts say scientific evidence of a link between the latest anti-depressants and homicide is thin.

“I think it got pulled out of a hat, frankly,” said Dr. Umesh Jain, a child and adolescent psychiatrist at Toronto’s Centre for Addiction and Mental health. “You could construct a weak and biologically plausible effect, but you’d have to be pretty convincing in court.”

Studies have established such drugs can increase the risk of young patients having suicidal thoughts. Their tendency to lift inhibition could also release some hostility or violence lurking in a person’s character, said Dr. Jain. Small studies like one he co-authored in 1992 have also suggested that the drugs can trigger short-term mania, especially in bi-polar disorder patients.

There is little or no scientific evidence directly linking the anti-depressants and serious violence or homicide, though, he said.

Still, the official “product monograph” approved by Health Canada for Prozac says the drugs are not recommended for use on adolescents, and warns that agitation, hostility and aggression might ensue. Doctors are allowed to prescribe medications “off label” to patients even when the approval does not expressly permit it.

Specialists in Winnipeg responded to concerns voiced by the accused’s parents by actually increasing the dose, said Greg Brodsky, the teenager’s lawyer.

“On Prozac he was becoming more irrational and aggressive,” Mr. Brodsky said. “That should have been a warning. That warning wasn’t heeded.”

SSRI drugs have a contentious track record. They were hailed originally as a safe alternative to older anti-depressants, then clinical-trial results came to light in 2004 that suggested they increased the risk of children and adolescents having suicidal thoughts.

Other studies have indicated they are effective in patients with major depression, but little better than a placebo for mild to moderate cases.

The Winnipeg murderer had a history of smoking marijuana, had abused prescription drugs and “experimented” with cocaine, but was trying to break free of that background when a family doctor prescribed Prozac for depression in July, 2009.

On Sept. 20, the accused met with Mr. Ottenbreit and another friend at his house, after the two friends had earlier stormed into his home, allegedly damaging the floor. The killer and Mr. Ottenbreit shared a cigarette, before the accused pulled aside a sweater on the floor of his garage, revealing the knife. He picked it up, “got this weird look on his face,” then abruptly stabbed his friend, the other boy told police.

“They were in my house, they dented the floor, I had nothing else to do but to stab him,” he told police later.

Dr. Keith Hildahl, clinical head of Winnipeg’s Child and Adolescent Mental Health program, testified that the Prozac might have played a role, but concluded on balance that his behaviour that summer was largely a result of the tense relationship he had with his parents.

Dr. Breggin, who has testified in a number of U.S. cases where anti-depressants allegedly led to murder or other violence and reviewed the Winnipeg case, pointed the finger of blame at the medication.

“These drugs produce a stimulant or activation continuum,” he said in an interview. “That continuum includes aggression, hostility, loss of impulse control … all of which are a prescription for violence.”

Dr. Breggin’s long-standing criticism of psychiatric drugs and opposition to the view that psychiatric problems have biochemical roots have prompted some supporters to call him the “conscience” of the speciality, and some psychiatrists and patient advocates to condemn him as a harmful influence.

Read article here:  http://news.nationalpost.com/2011/12/07/prozac-defence-stands-in-manitoba-teens-murder-case/

See Michael Moore discuss the need for an investigation into psychiatric drugs causing violence:

See Fox National News on School Shootings and Psychiatric Drugs:

To read international warnings and studies on psychiatric drugs causing violence – visit CCHRInt’s Psychiatric Drug database and simply type in keywords such as violence, mania, psychosis, aggression in the red search box

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Online database lets you research the side effects of common psychiatric drugs

Thursday, September 15th, 2011

Natural News – September 15, 2011

by M.K. Tyler

(NaturalNews) If you have ever seen a commercial for a pharmaceutical drug, you are probably familiar with the long list of dangerous side effects that are rattled off in the last five seconds of the advertisement, just after viewers are told how Drug “X” is going to save their lives, improve their memories or give them unlimited energy. What was that? Did he just say that pill might cause bleeding out of my eyes?

Drug companies do a great job – and spend a lot of money – to ensure that most consumers aren’t aware of the harmful side effects of common drugs prescribed for conditions like depression, heart disease, arthritis, ADHD or high blood pressure. Unfortunately, the result of this has created a society where the average person with a health problem is captivated by the promises delivered in clever advertising. There is a drug for everything? All I have to do is talk to my doctor? How convenient.

But what if there was a way to take back control of our lives and our health? What if, despite talking to your doctor, you still have questions or concerns about the safety of a drug?

The Citizens Commission on Human Rights International (CCHR) has a database that allows you to do just that. It’s called the Psychiatric Drug Database, and it allows consumers to research the potential side effects of common psychiatric drugs, such as Ritalin or Wellbutrin.

While the database is limited to psychiatric drugs, this type of public information portal represents a significant step in the right direction to help patients find unbiased information and make informed decisions about their health.

The database allows you to search by drug and will retrieve information about adverse reactions reported by patients who have taken the drug, international warnings and studies that have been done on the drug and what side effects different age groups or genders have experienced. For example, a search of the effects of Ritalin on 18-30 year old women retrieved 89 reported cases of adverse side effects.

These effects including anxiety, fatigue, hypertension, tremors, chest discomfort, nausea, panic attacks, cardiac murmurs, aggression, suicide attempts and completed suicides. The results are broken down by case and list specific symptoms and reactions caused by the drug in each reported case.

Another search of Zoloft and its effects on young children included cases of cerebral disorders, upper respiratory tract infections, sleep disorders, vertigo, hallucinations, psychomotor hyperactivity and suicidal ideation.

The database only includes information on cases that were actually reported to the FDA’s Adverse Event Reporting System between 2004 and 2008. Based on the FDA’s own estimates, only about 1 to 10 percent of adverse drug side effects are even reported to the FDA. The CCHR’s database, therefore, represents only a small margin of the population that has been affected by adverse side effects of pharmaceutical psychiatric drugs.

Visitors to the site will also notice an interesting anecdote that describes how the definition of poison – a substance that causes death or harm when consumed by a living organism – clearly characterizes the drugs listed in the database. Consumers are encouraged to research potential problems of a drug before agreeing with their doctors to start a course of therapy.

To find more information about a particular drug, visit www.cchrint.org/psychdrugdangers

Sources for this article include

http://www.cchrint.org/psychdrugdan…

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U.S. doctors steeped in financial ties – drug money from Big Pharma

Monday, September 12th, 2011

Natural News – September 11, 2011

by S. D. Wells

Pharmaceutical firms in the United States are shelling out massive funds for doctors travel and entertainment expenses in hopes of boosting sales of new drugs. More than 160,000 doctors have received related payments in 2011 already.

The big push includes free samples, hospital detailing, journal ads, gifting, and the sponsoring of continuing medical education, but patients fear this all leads to doctors prescribing popular, money making drugs instead of following standard of care practices .

Pfizer, Eli Lilly, and AstraZeneca top the list of companies also spending far more on “marketing” than on research, with a total estimated $57,000 billion in overall marketing expenditures in just one year in the United States.

Pharmaceutical giants are claiming they are just trying to be open about how they conduct business, but the statements come at a time of intense scrutiny, and after several prosecutions regarding unlawful marketing practices.

In fact, some of these databases were actually set up as part of settlements of federal criminal investigations into the illegal marketing of drugs to doctors. Many companies have not released any data whatsoever, but Lilly and Pfizer combine to have paid out over 90 million dollars.

United States government agencies are preparing guidelines that will make such information mandatory by 2013. Currently there are over 80,000 pharmaceutical sales reps in the U.S. pursuing about 800,000 pharmaceutical prescribers, so it can be extremely difficult to track the money for one doctor from several sources, or to identify the largest recipients, like an entire hospital, without laborious work by a whole team of computer experts.

By 2013, new federal healthcare laws are expected to make it easier for the public to track a doctor’s payments from multiple companies; however, there may be controversial business opportunities available in the setting up and running of these supposedly transparent websites, such as PharmaShine, which was founded auspiciously by a former attorney for Merck.

Critics are complaining about the extreme conflicts of interest that arise from all the gift giving and promotional items, saying doctor’s can negatively influence the cost of medicine by recommending or prescribing brand name drugs over cheaper generics. In many instances, the reward is substantial for doctors to do exactly that. Over 380 doctors have earned more than $100,000 from drug companies in just the past two years.

But there is also a flip side to these perks. One doctor said he had to follow a slide show presentation word for word in order to receive funding for a speaking engagement promoting certain pharmaceuticals, or there would be changes made to his contract.

On top of all the other problems inherent in proper ethics and disclosure, many prominent doctors at academic medical centers have failed to disclose millions of dollars in drug company payments, and Federal prosecutors say some payments are really kickbacks for illegal or excessive prescribing. Are doctors now moonlighting as drug salesmen in order to keep the perks flowing?

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Dollars for Docs Update: Now With 12 Companies, More Than $760 Million in Payments

Wednesday, September 7th, 2011

ProPublica – September 7, 2011

by Dan Nguyen, Charles Ornstein and Tracy Weber

Drug companies have long kept secret details of the payments they make to doctors and other health professionals for promoting their drugs. But 12 companies have begun publicizing the information. ProPublica pulled their disclosures into a database so patients can search for their doctor.

For decades, drug companies kept the names of their speakers — and how much they paid them — secret. But over the past two years, companies have begun posting this information on their web sites, some as the result of legal settlements with the federal government.

ProPublica took these disclosures and assembled them into a single, comprehensive database that allows patients to search for their physician.

It was not easy. Some of the firms constructed their sites in a way that made it near impossible to analyze or, in some cases, even download their data. And each firm disclosed its data differently. Some, for example, simply included speaking. Others also detailed consulting. Sometimes, research, business travel costs and meals were listed, too.

ProPublica will update the database from time to time as additional companies release their payment data. Federal law requires that all companies publicly report this data beginning in 2013. That information will be posted on a government web site.

Several things to bear in mind about the data:

  • Only the companies that have disclosed payments on their web sites are included. Their combined prescription drug sales amounted to about 40 percent of the U.S. market in 2010. Though a substantial share, the data may not be wholly representative of the industry.
  • The data is from payments made in 2009, 2010 and, in some cases, the beginning of 2011. But not all companies reported payments for every quarter during that period.
  • Companies are continually updating their data, so the most recent additions may not be included in our database.
  • Although most of the money went to physicians, other practitioners, including nurses and pharmacists, also work with pharmaceutical companies and are listed. Some drug firms include these payments; others do not.
  • Practitioner names and addresses (city/state) are listed as the companies released them and may vary. For instance, some companies include a middle initial, and others do not. Some companies also list different cities for the same individual. This may happen because professionals may have practices in multiple locations or because they provided different addresses for payment.
  • As noted above, the companies’ reports cover different periods and include payments for different services. Some companies include payments only to speakers, while others include consultants and advisers, as well as research, meals and business travel. (Details are included on each company’s page.)
  • The reports include both the name of the health provider who performed the service as well as the entity paid. They may be different.
  • Research payments are distinct from speaking and consulting. Payments for clinical studies may include costs associated with patient care, supplies, as well as the time spent by health care professionals treating patients and managing the study. The figure listed may not reflect the actual compensation received by the physician listed as the principal investigator.
  • A physician on the list may be getting money from other companies that have yet to disclose payments.
  • Eli Lilly has in some cases used different middle initials for the same individual.
  • This list does not include payments for speaking at continuing medical education courses, which are run independently from the pharmaceutical companies.

http://www.propublica.org/

 

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Physicians on Pharma’s Payroll: Educators or Marketers?

Thursday, November 18th, 2010

WNCY NEWS November 18, 2010

by Alisa Chang

Most people getting a prescription for a drug don’t ask if their doctor is getting paid to promote that drug.  But thousands of physicians all over the country get paid by pharmaceutical companies to speak about brand-name medications. Some have made more than $300,000 in the last 18 months. And at least 1,500 of these speakers are licensed in New York. All these details have just come to light after the investigative news organization ProPublica compiled a database based on disclosures made by seven pharmaceutical companies after federal lawsuits.

(See a list of New York’s top earners and check and see if your health provider has received funds here.)

For more than 20 years, psychiatrist Richard Schloss has been treating Long Island patients with schizophrenia, bipolar disorder and social phobias.  But he has another job. Pfizer has paid him thousands of dollars to tell other psychiatrists about a drug the company sells, an anti-psychotic medication called Geodon.

In all his years of speaking for Pfizer, the company’s never asked Schloss (right) about an embarrassing stain on his state record. In 2001, the New York State Health Department suspended Schloss and then put him on probation for five years for helping supply Vicodin for a year and a half to six patients who were drug addicts.  Schloss says he didn’t know at the time those patients were lying to him about their pain symptoms.

“I was just trying to be compassionate and was misguided and maybe a little naïve, but that was 10 years ago that the disciplinary action occurred based on incidents that occurred 13 years ago. So I feel like I’m a different doctor than I was then,” said Schloss, “and it doesn’t really detract from what I know and what knowledge I can impart about the medications that I speak for.”

Drug companies say the goal of their speaker programs is to educate — and that they merely pick the best experts to teach fellow doctors about the latest drugs. But many people in the medical community disagree with those claims and want to see the practice end. They say the way drug companies recruit and script their speakers has less to do with education and more to do with marketing.

Speakers With Tainted State Records

Among the 17,000 speakers in the ProPublica database are hundreds of doctors like Schloss — doctors with tarnished state records who have been paid by drug companies to teach other physicians about the latest medications. Schloss says he doesn’t know if Pfizer even knows about his record.

“They didn’t bring it up, and I didn’t volunteer it but if they asked, I would have been forthcoming, obviously,” said Schloss.

ProPublica’s database for New York doctors shows GlaxoSmithKline recruited a physician after he was suspended for unzipping his pants and fondling himself while examining a female patient. An Eli Lilly speaker wrote fake prescriptions for Ritalin to feed his own addiction. And Johnson & Johnson hired a doctor who lost his New York license after giving patients drugs that weren’t approved for human use. Medical ethicists are now asking if drug companies are checking the state records of their speakers.

“It shows that drug companies aren’t necessarily that selective in who they’re using to promote their products. They will take people who will do what they need them to do,” says Susan Chimonas, a researcher at the Center on Medicine as a Profession at Columbia University. “Their number one concern is making money for their shareholders. That is their legal obligation. And if they can’t find enough physicians with unblemished records to go out and push their products for them, they will take who they can get.”

When WNYC asked Pfizer and other companies how these doctors ended up on their speaker lists, none would grant interviews. Some of them have told ProPublica they do conduct background checks on their speakers, but are now re-evaluating the process.

Targeting High Prescribers

To be clear, the doctors with blemished state records only comprise about one percent of the New York speakers in the database. That is about the same percentage of doctors who are disciplined every year in New York. But evidence from these speaker programs raises troubling questions that go far beyond doctors with blemished records. The companies insist these programs are purely educational, and they get the best teachers they can find. But documents and interviews with several physicians chip away at that claim.

First, the industry says it picks the doctors who are the most knowledgeable about the drugs. But Schloss said Pfizer first picked him because he was a high prescriber of Geodon.

“What they do is they get the pharmacy records, and they know who’s prescribing what,” said Schloss, “and they can come in and say, ‘I see you’re prescribing, you know, a lot of, in this case, Geodon. What do you like about it?’ And you if say nice things, they say, ‘Will you be interested in speaking for us?’”

Schloss said he agreed to be a speaker because he genuinely believes in Geodon, and he enjoys teaching. But even he admitted the speaking has actually changed the way he prescribes.

“You know, I may use Geodon maybe 10 percent more than I did before I was a speaker,” said Schloss. “I use it 10 percent more because I’ve spoken about it so many times, and thereby, learned a lot more about what the drug can and can’t do.”

Read the rest of the article here: http://www.wnyc.org/articles/wnyc-news/2010/nov/18/physicians-pharmas-payroll-educators-or-marketers/

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Psychiatrists Dominate “Doctor-Dollars” Database Listing Big Pharma Payments

Friday, October 22nd, 2010

Medscape, October 22, 2010

Shelley Wood and Robert Lowes

October 22, 2010 — Psychiatrists dominate a list of physicians receiving the most in payments from pharmaceutical companies, according to a free, interactive database of such payments launched by investigative journalism group ProPublica, in partnership with other US media outlets

So far, the database includes payments made by 7 of the biggest pharmaceutical companies — some of which the US Department of Justice has required to disclose physician payments as part of settlement agreements over illegal drug marketing — which account for a boggling $258 million in payments to roughly 17,700 physicians. The plan is to add 70 more companies.

Any US physician is searchable by name in the database.

“Receiving payments isn’t necessarily wrong,” says the homepage for the Dollars for Docs, “but it does raise ethical issues.”

The payments covered by the project include fees for such items as speaking, consulting, meals, and travel; the different types of payments from different companies have been compiled, streamlined, and tallied by ProPublica.

The 10 highest-paid physicians in 2009 to 2010 for each of the 7 companies are listed on the site, spanning all medical disciplines.

Endocrinologist Firhaad Ismail, MD, from Las Vegas, Nevada, ranked number one in pharmaceutical industry compensation, receiving $303,558 from GlaxoSmithKline, Eli Lilly, and Merck. Dr. Ismail did not return messages left with his office requesting an interview.

Top-Paid Psychiatrist Says Payments Do Not Cloud Clinical Judgment

ProPublica researchers also compiled a list of physicians who were paid more than $100,000 (typically from more than 1 company) during the past 18 months, turning up 384 names, including 41 who earned more than $200,000 through speaking or consulting arrangements and 2 who earned more than $300,000 from 1 or more of the 7 companies.

More psychiatrists are listed in the database than any other kind of specialist. Of the 384 physicians in the $100,000 group, 116 are psychiatrists. Leading all psychiatrists was Roueen Rafeyan, MD, in Chicago, Illinois, who received $203,936 from Eli Lilly, AstraZeneca, Johnson & Johnson, and Pfizer, mostly for professional education programs.

In an interview with Medscape Medical News, Dr. Rafeyan said that compensation from pharmaceutical companies does not cloud his clinical judgment at the expense of patients.

The day I’m influenced by that is the day I’m not fit to practice medicine,” Dr. Rafeyan said.

He noted that the majority of the drugs he prescribed were generics. “If someone looked at my prescribing patterns, it would be the opposite of the [pharmaceutical] money I receive,” said Dr. Rafeyan, an assistant clinical professor at Rush University Medical Center in Chicago.

Dr. Rafeyan said that although the extra income is always welcome, patient well-being was his prime motivation to talk to other physicians about brand-name psychiatric drugs. “When you educate other physicians, hopefully 1 patient will benefit from it.”

When asked how he found the time to earn more than $200,000 as a pharmaceutical company educator over 18 months, Dr. Rafeyan said, “I work very hard, like many other physicians. None of us have 40-hour work weeks.”

Dollar Value of Psychiatric Drugs Is Enormous

The preponderance of psychiatrists on the ProPublica list may reflect the proportion of prescription activity involving psychiatric drugs. In 2009, the dollar value of antipsychotic drugs came to $14.6 billion, topping all other therapeutic classes, according to research firm IMS Health. Antidepressants occupied the number 4 spot on the list, valued at $9.9 billion.

IMS Health put the total US prescription market in 2009 at $300.3 billion.

Carol Bernstein, MD, president of the American Psychiatric Association, told Medscape Medical News that the thorny issue of pharmaceutical industry compensation went beyond her specialty.

People with high-profile, high-visibility [positions] sometimes get carried away.

“Academic medicine needs a different relationship with the pharmaceutical industry,” she said. Physicians must find new ways to facilitate the development of new drugs that do not compromise their ethics or patient care.

“People with high-profile, high-visibility [positions] sometimes get carried away,” she said.

Research has shown, Dr. Bernstein added, that heavy pharmaceutical marketing indeed influences physician prescribing.

Read the rest of the article here:  http://www.medscape.com/viewarticle/731028

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Drug Companies Hire Troubled Doctors As Experts

Wednesday, October 20th, 2010

NPR is investigating how pharmaceutical company payments to physicians are influencing physician prescription practices in partnership with ProPublica, an independent, nonprofit newsroom that produces investigative journalism in the public interest.

This collaboration also includes The Boston Globe, the Chicago Tribune, PBS Nightly Business Report and Consumer Reports.

Pfizer Headquarters in New York City

Mark Lennihan/AP— Pfizer, one of the largest drug makers in the U.S., saw $27.8 billion in sales in 2009. Seven drug companies, including Pfizer, have disclosed information about doctors who receive payment for speaking fees related to products they sell.

by NPR Staff and ProPublica

October 19, 2010Drug companies say they hire the most-respected doctors in their fields for the critical task of teaching about the benefits and risks of the companies’ drugs.

But an investigation by ProPublica has uncovered hundreds of doctors receiving company payments who had been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.

To vet the industry’s handpicked speakers, ProPublica created a comprehensive database that represents the most accessible accounting yet of payments to doctors. Compiled from disclosures by seven companies, the database covers $257.8 million in payouts since 2009 for speaking, consulting and other duties. The companies include Lilly, Cephalon, AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck and Pfizer.

Although these companies have posted payments on their websites — some as a result of legal settlements — they make it difficult to spot trends or even learn who has earned the most. ProPublica combined the data and identified the highest-paid doctors, then checked their credentials and disciplinary records.

That is something not all companies do.

“Without question, the public should care,” said Dr. Joseph Ross, an assistant professor of medicine at Yale School of Medicine who has written about the industry’s influence on physicians. “You would never want your kid learning from a bad teacher. Why would you want your doctor learning from a bad doctor, someone who hasn’t displayed good judgment in the past?”

ProPublica senior reporter Charles Ornstein detailed the findings with Morning Edition‘s Renee Montagne.

NPR: Tell us a little about the database. What have you found, and who’s on it?

Charles Ornstein, ProPublica: For many years, the pharmaceutical industry has been paying doctors to speak and consult on their behalf, but the names of those doctors have largely been a secret. So, for the first time we’re seeing from the companies who they’re paying for. Now we have a chance to take a look at their backgrounds and what they’re doing for the money.

What are these 17,000 doctors listed in the database doing for the seven drug companies that have released information?

The drug companies rely on doctors to speak locally and travel around the country to educate other doctors about the risks and benefits of the drugs. And they can get paid a lot of money. In our database we found that there were 384 doctors who, over the course of just the past 18 months, have received at least $100,000 from the drug companies that have reported so far.

What kind of money are we talking about, and what is that buying the drug companies in the way of sales?

We’re talking about big money. Just from these seven companies, they’ve paid out more than $257 million in the past 18 months, and remember not all of these companies have even disclosed their payments for that whole period of time, so it’s likely going to be substantially more, just for these seven companies.

What do they get for it? They wouldn’t be spending this kind of money if they weren’t getting returns from the perspective of increasing their brand in the market, letting doctors know about it, encouraging them to prescribe it. They say that doctors’ success at increasing prescriptions is not a means in which they’re measured, but some of the lawsuits against the industry have said that prescriptions and return on investment absolutely play a role.

And you have found among those doctors a few who have backgrounds that are a bit shocking, especially considering they’re representing these drug companies and, in a sense, representing themselves as experts.

If you take a look at the pharmaceutical company websites, you see that they take great pride in that they’ve recruited the top names in the field, the leading experts and academicians to speak on behalf of their products and consult with them, and when you start looking at the backgrounds, you find some, indeed, are the top names in their fields. But some you can’t find any information about.

We found several dozen of the top speakers did not have board certifications — which means they were not certified in their medical specialties — and then we found more than 250 doctors who had some type of sanction taken against them by a state medical board. And we just looked at a sampling of states.

Some of the discipline was really quite serious. The Ohio Medical Board, for example, voted a couple of years back to revoke the license of William David Leak, whom they accused of performing unnecessary nerve tests on 20 patients and subjecting some to an excessive number of invasive procedures. Dr. Leak is appealing the penalty, and his license is still active, but since 2009 he has received $85,000 from Eli Lilly and Co.

Another one is a hospital disciplinary case out of Georgia — the state appeals court in Georgia in 2004 upheld a hospital’s decision to kick Dr. Donald Ray Taylor off its staff. He’s an anesthesiologist, and he admitted to giving young female patients rectal and vaginal exams without documenting why. He had also been accused of exposing women’s breasts during medical procedures, and when he was confronted by a hospital official, he said, “Maybe I am a pervert; I honestly don’t know.”

Dr. Leak did not return our phone calls, but I did talk to Dr. Taylor. He said that these incidents happened long ago, that they were old news and happened in the 1990s and didn’t want to talk about them, so he didn’t comment one way or the other, but he did say that nobody raised any issue one way or the other about his medical practice. And that’s really what was most important here — that his medical practice was not called into question.

The Survey Says…

Consumer Reports conducted a survey about the promotional activities of doctors on behalf of pharmaceutical companies.

The survey, conducted in October 2010, included 1,250 randomly selected adults in the U.S.

Highlights are below:

Some doctors take payments from drug companies in exchange for promoting the benefits of those companies’ drugs to other doctors in presentations at conventions and conferences.

Do you approve or disapprove of doctors taking such payments in exchange for promoting specific drugs to other doctors?

CR Survey Q4

Over the past five years, have you been told by a doctor you saw for medical treatment that he or she has taken payments from drug companies?

CR Survey Q5

Would you feel comfortable asking a doctor who is about to prescribe a drug for you if he or she has taken payments from the drug company that manufactures that drug?

CR Survey Q6

In general, how concerned would you be about the quality of treatment or advice you would get from a doctor who took payments from drug companies? Would you be …

CR Survey Q8

In your opinion, how often do you think doctors who take payments from a drug company would be biased enough by the money taken to prescribe that company’s drug even if that drug was no better and/or more expensive than an alternative drug that was available? Would you say …

CR Survey Q10

So put it in perspective. Of all of these doctors — and you’re really talking tens of thousands doing speaking — what does this represent? A few bad apples?

When we spoke to experts about this, what came up was that Pharma essentially has their choice — they get to pick the best of the best, and they have the pick of the litter. What one Yale professor told us is that the public definitely should care, because just as you wouldn’t want your child learning from a bad teacher, you wouldn’t want your doctor learning from a bad doctor. And if that person has displayed bad judgment in the past, what does that portend for what they may be speaking about when they are talking in front of doctors?

When you presented these findings about these doctors who had some real problems in the past to the drug companies, what did the companies say to you?

We asked the drug companies how they screen their doctors, because we felt that was a really important question. For the most part, they said that they relied on the doctors to tell them if they ran into trouble, or they checked federal databases to see if their misconduct had barred them from participating in federal health programs. But we didn’t find but two of the companies that said they checked state medical board websites to see if the doctors were disciplined in those states.

Did any of them suggest they were going to change?

The companies said that they’re certainly going to look into the doctors that we brought to their attention, and they also said they would be looking at their practices. So I think time will tell whether they take a more comprehensive look at the doctors before they hire them to go out and promote their products.

In the story you wrote for ProPublica.org, you talk about doctors who defend their speaking fees as purely educational. In some cases these are experts who go to rural areas where doctors can’t always attend conferences or meetings of experts. Is it the case that some of these payments to doctors for speaking about these products are actually doing some good?

Absolutely. I think one thing that can’t get lost here is that pharmaceutical products have been innovative and have saved lives and provided treatments for diseases that in the past there haven’t been treatments for. So without question, some drugs are absolutely necessary, and the more patients who take them, the better off society will be.

I think the question that some folks have raised is whether or not the drugs that are being excessively promoted are indeed those drugs that have really the breakthrough, the groundbreaking potential. But it does make a huge difference.

To give you an example: GlaxoSmithKline — their top drug that they’re using speakers for is a drug called Avodart, which is for enlarged prostate. And over the past five years, Avodart, which is really locked in a heated battle with another drug, has seen its sales more than quadruple and its market share double. So this has a huge effect.

I think what you hear from critics of the industry is that perhaps when they’re promoting drugs, they’re not suggesting what the alternatives could be — whether it’s watchful waiting or physical therapy or changes to diet and exercise.

In the interest of allowing patients to make some of these decisions themselves, ProPublica has compiled a database so people can search for their own doctor.

We have seven companies, and we’ve combined them all into one database, which was not easy to do. The documents they put on their websites and the databases they put on their websites are not easily analyzable and in some cases you can’t download them or even find out who the top speaker is.

So we are making available access to these doctors. You can search by state, you can search by company, you can search by doctor’s name. And we’re also letting folks have the ability to tell us if one of these doctors is their doctor, and what their experience has been with them. So this is really an opportunity to interact in a two-way conversation with the public about the doctors that work with the industry and hear what the public has to say about their experiences.

Folks will easily be able to look up the names of their doctors and pretty easily find if they’ve taken money from these seven companies.

They won’t know a couple of things. First, more than 70 companies have not yet publicly reported whom they have paid to promote their drug. You won’t see those in the database quite yet. But you also won’t know exactly what they’ve done for the money and if it’s influenced their prescription practices. And I know that we’re planning to continue our reporting in the coming months to provide additional clarity on that for the public.

What’s the use someone could practically put that information to?

We have extensively talked to experts across the country with that very question, and I think what we heard time and again was, if you see your doctor as receiving money from a company that makes your drug, it’s good to ask if there are alternatives that are less expensive, if there are alternatives that have fewer side effects, and to just exercise a degree of caution — not necessarily to distrust your doctor at all, but to ask questions to make sure that this is the drug that’s best for you.

Read the rest of this article here: http://www.npr.org/templates/story/story.php?storyId=130644774&ps=cprs

Explore the database Dollars for Docs logo

Dollars for Docs: What Drug Companies are Paying Your Doctor here: http://projects.propublica.org/docdollars/


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