Wednesday, June 27, 2007

Payola Part Two

In an article that will shock roughly none of my readers, New York Times reporter Gardiner Harris reports that

"As states begin to require that drug companies disclose their payments to doctors for lectures and other services, a pattern has emerged: psychiatrists earn more money from drug makers than doctors in any other specialty."

You may recall that Harris reported on this payola issue in an earlier article, focusing on the state of Minnesota. The story discussed the payments from drug companies to doctors – the results indicated that drug companies paid Minnesota psychiatrists large amounts of money to stump for their products. I added my commentary as well as a description of how this process is important in creating “key opinion leaders” who serve as both physicians and talking advertisements for drugs.

This time, Harris wrote about Vermont, and the results are unsurprising. In the Green Mountain State, Vermont officials reported that

drug company payments to psychiatrists in the state more than doubled last year, to an average of $45,692 each from $20,835 in 2005 (see update below). Antipsychotic medicines are among the largest expenses for the state’s Medicaid program.

Later in the story, Harris writes that

Officials in Maine and Vermont said they would try to compare reports of payments to doctors with Medicaid records to explore how marketing practices might influence prescribing in ways that increased costs to taxpayers.

Well, when the analyses that are pending in Maine and Vermont were run in Minnesota, they found what appears to be a strong relationship between receipt of drug company money and prescription rates of atypical antipsychotics to kids.

The Vermont report appears to not have provided as much information as the Minnesota report, but the similarities are notable. The article also reported that several states are considering similar legislation that would require disclosure of drug company payments to doctors. The big question is how much money drug companies will invest in sinking such legislation.

Thanks to Gardiner Harris and the New York Times for the reporting. Keep it up.

Hat Tip: Mind Hacks

UPDATE (6-28-07): A helpful reader comment noted accurately that the NYT article cited above only refers to a group of top recipients of funding, so the average Vermont psychiatrist made much less than $45k in drug company funds in '06. My apologies that this point was not made clearly in my original post.

3 comments:

Mark said...

That explains alot.seriously.

Dr X said...

Perhaps I'm missing something in my own reading of the Times article, but the $45,000 figure described as the average payment to psychiatrists represents the average among only the top 11 recipients in the state. It is not a statewide average for psychiatrists, as the Times article leads one to believe.

I did my own quick and dirty analysis based upon the report issued by the State of Vermont and it looks to me like gifts, education and payments totaling an average of $1000 per psychiatrist are probably typical for the average psychiatrist in Vermont.

I'm thoroughly in sympathy with your concerns and applaud the work you're doing in this blog, but this particular report from The Times could mislead readers.

Radagast said...

Why is it that psychiatrists are "targeted" in this way, if that's the right word?

Matt