Open Payments Website Shows Billions in Payments to Doctors

Doctor holding piggy bank

Do drug companies have your doctor on the payroll?

More than half a million American doctors and nearly 1,360 teaching hospitals were paid $3.5 billion over five months last year by pharmaceutical and medical device companies, a new federal website has revealed. Some of the companies are among the bigger makers of prescription opiates that physicians have overprescribed, contributing to an epidemic of addiction and fatal overdoses.

The data released Sept. 30 with the launch of the government Open Payments website is meant to help consumers monitor their physicians for financial bias. The Affordable Care Act required the site’s creation. It’s had a rocky start, a top healthcare news team reported: it’s overly complicated for consumers with delays and voids of data including many doctors’ names.

And days after the initial release, the government reported an additional $1.1 billion in drug company payments where the benefactor was not named because it had challenged the accuracy of the information or was linked to a drug or device not yet on the market. Those were in addition to the original disclosures.

“When you look at why do drug companies and device companies make gifts and offer consulting payments and honoraria to physicians, the main goal is to influence prescribing practices,” Dr. Michael Carome, director of Public Citizen’s Health Research Group, told the New York Times. “The interest of those companies is to improve their financial bottom line, and not necessarily represent the best interest of patients.”

The data that came in a first cache from August through December 2013 showed companies paid 546,000 individual doctors and 1,360 teaching hospitals a total of $3.5 billion in 4.4 million payments. These were the results explained by officials of the Centers for Medicare and Medicaid Services, the federal agency administering those health programs. For speaking and consultant fees in less than half a year, physicians in the U.S. were paid about $380 million by pharmaceutical drug and medical device makers.

Other Findings

  • $1.5 billion in payments went to research
  • Some doctors and hospitals were paid millions in royalties for products they helped develop
  • Overall, companies spent $302 million on royalties
  • $202.2 million was paid to doctors for promotional speaking

“Financial ties among medical manufacturers’ payments and healthcare providers do not necessarily signal wrongdoing, the CMS noted in announcing the results. “Given the importance of discouraging inappropriate relationships without harming beneficial ones, CMS is working closely with stakeholders to better understand the current scope of the interactions among physicians, teaching hospitals and industry manufacturers. CMS encourages patients to discuss these relationships with their healthcare providers.”

Companies are required by the Affordable Care Act to document payments to teaching hospitals, medical doctors and specialists such as dentists, optometrists and chiropractors. But according to the new website, 69 percent of the spending went to medical doctors, with 25 percent given to teaching hospitals. The other recipients received only a small fraction of the total outlay.

Because of wrong or conflicting information, the CMS estimated 40 percent of recipients – representing 60 percent of total industry payments – were not named, but vowed to have the full year’s data and identifications in the 2015 report. One of the leading news organizations probing the financial relationship between for-profit companies and doctors, the nonprofit investigative news agency ProPublica, reported that names were also omitted for 90 percent of the research recipient doctors or university hospitals; other payments were attributed by the likes of Johnson & Johnson to their subsidiary companies, making it difficult to accurately track the spending.

The extensive financial relationships between some doctors and teaching hospitals and the giant pharmaceutical industry have been the source of an ongoing investigation by reporters and cause for concern among consumer advocates.

Health journalists from the New York Times and ProPublica jointly reported an analysis and breakdown of the freshly released data. In the last half of 2013 alone, companies paid doctors and teaching hospitals.

  • $92.8 million for food and beverage
  • $74.1 million for travel and lodging
  • $32.1 million in grants
  • $4.2 million in accredited training

Many media organizations around the country have published ProPublica’s ongoing project called “Dollars for Docs,” which has just been updated. Enter your doctor’s name and with one to two clicks, you can see whether that healthcare provider has been paid by the industry and how much.

Prescription Painkiller Epidemic

The Open Payments website comes six months after the U.S. Centers for Disease Control and Prevention reported that physicians are the leading source of prescription painkillers for the most high-risk opioid addicts. The CDC found that while most pain medication abusers get them from friends or family, the hard-core users – those most likely to overdose – are able to get a doctor’s prescription for the powerful opiates, OxyContin among them. The CDC called for doctors to perform a more thorough background check on patients’ abuse risks by checking state prescription drug monitoring programs.

And in May, the district attorneys of two California counties sued five giant pharmaceutical companies, charging that they fraudulently marketed as safe for chronic pain some powerfully addictive opiate drugs made only for dying cancer patients. As a result, the counties alleged in their suit, use of prescription painkillers has rocketed and the U.S. has been left with an alarming rise in fatal opiate overdoses.

Named in the suit were Actavis, Endo Health Solutions, Johnson & Johnson’s Janssen Pharmaceuticals, Purdue Pharma, which makes OxyContin, and Teva Pharmaceutical Industries’ Cephalon.

Although some highly paid physicians will likely bear more attention, The Times story noted that medical breakthroughs and technical advances result from funding researchers and doctors to run clinical trials to usher products toward FDA approval and public access.

Representatives for many of the pharmaceutical companies involved scoffed at the findings and aimed arrows at the underlying source of the data – a database brought to us by the makers of the problem-plagued website for Affordable Care Act enrollment.

One of the country’s respected healthcare watchdogs, Pulitzer Prize-winning Charles Ornstein of ProPublica, wrote that if the database were a product, it would be recalled by now. But consumer advocates consider it a start in the right direction.

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