Mar. 1, 2013 — Drug
companies spent nearly $84 million marketing pharmaceuticals in the
District of Columbia in 2011, including an outlay of nearly $19 million
for gifts given to physicians, hospitals and other health care
providers, according to a report by researchers at the George Washington
University School of Public Health and Health Services (SPHHS). The
report notes that 12 physicians in the District received gifts
(including consulting payments) that totaled more than $100,000 apiece
that one year alone.
"There is nothing inherently wrong with such
gifts," said Susan F. Wood, PhD, lead researcher and an associate
professor of health policy and of environmental and occupational health
at SPHHS. "However, this report draws attention to the amount being
spent on marketing drugs and raises questions about whether some heavily
marketed drugs may be prescribed more extensively than is appropriate."
The
report fulfills the requirement of a 2004 law in the District of
Columbia that requires all pharmaceutical companies to file annual
reports describing their prescription-drug marketing activities in the
District. The AccessRx Act also requires analysis of these reports to
determine how pharmaceutical marketing may affect healthcare services in
the District.
In fact, a previous study by Wood and her
colleagues showed that drug companies making antipsychotic drugs gave a
disproportionate amount of gifts and payments to District psychiatrists
who treat Medicaid patients. Close ties between the drug companies and
psychiatrists might have led to inappropriate prescribing for Medicaid
patients, and particularly for children, according to D.C. Council
Member David Catania, who held a hearing on the issue last November.
"Antipsychotics
are often prescribed to children who are not in fact psychotic but have
behavioral problems," said Adriane Fugh-Berman, MD, a co-author on both
reports and an associate professor of pharmacology and physiology at
Georgetown University Medical Center. "These powerful drugs also act as
sedatives and might lead to less disruptive behavior, but at what cost?"
Antipsychotics are also associated with health problems including
obesity and Type II diabetes, she said.
The current report
doesn't single out specific drugs or name any doctors or other providers
but it does give an overview of the money that drug companies spent on
marketing their products in the District. The report notes that drug
companies spent a total of $83.7 million for advertising, gifts and
aggregate expenses in 2011 -- slightly less than 2010. Still, the report
found that a small number of companies -- 23 out of 158 -- reported
marketing expenditures of more than $1 million apiece. "That is an
astonishing amount of money being spent on marketing prescription drugs
in the District," said Wood.
The report also found that 22
percent of total marketing expenditures, or $18.9 million, went to
"gifts" -- a category that included grants, speaker's fees and food.
Drug companies may treat a select group of doctors to dinner and a sales
pitch at a local restaurant, as well as provide delivered meals to
medical practices, Wood said.
Hospitals, clinics and other
organizations received gifts totaling $9.7 million, and individuals
received $9.2 million. Some nurses and pharmacists received gifts in
2011 but most of the pharmaceutical company largesse, nearly 82 percent
went to doctors. Most gifts to doctors were described by the drug
companies as speaking fees and were paid in the form of cash or checks,
the report said.
Other findings of the report include:
- Out
of nearly 3,400 physicians in the District who received at least one
food gift, 444 received ten or more meals from pharmaceutical companies
during 2011 and 33 physicians got 52 or more of these food gifts. This
finding suggests some physicians are dining with drug reps on a weekly
basis.
- The top ten professional organizations
(representing health professionals in a specific specialty or
demographic group) received a total of $3.5 million, with half of those
gifts valued at $20,000 or more.
- The top ten
Disease-Specific Organizations based in the District received $2.1
million in gifts such as cash or checks from drug companies. These
organizations often represent and advise patients, and the concern is
that large gifts could sway such groups to favor or recommend the
company's products, the report said.
The report, which was
commissioned by the Department of Health (DOH) in the District of
Columbia, notes that under the Affordable Care Act pharmaceutical
companies will begin publicly reporting gifts to physicians and teaching
hospitals in September 2014. At that time, the authors say that the
District could publicly release the names of all gift recipients, a step
that would allow patients to have information about the financial
relationship between drug companies and all of their health care
providers.
Source:
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