How Much Does Your Doctor Take from Drug Companies?

Palo Alto doctors have taken over half a million dollars from drug companies over the last three years for meals, trips, lectures and consulting fees.

For years, drug companies hid numbers like that from consumers, but as a result of federal lawsuits, two years ago they began making them public on their websites, although not always plainly. The journalists at ProPublica have compiled a nationwide database of what doctors are taking. You can access it here by doctor's name or city.

Among the top local beneficiaries were clinical instructor Ian Carroll, who took $74,588 from the drug company Eli Lilly as a speaker; Stanford child and adolescent psychiatrist Hans Steiner who took $70,950 from Eli Lilly as a speaker; and psychiatrist Bibi Das, a private practitioner who received $58,790 from AstraZeneca also as a speaker.

Stanford University implemented a policy in 2006 disallowing faculty, clinicians, students, and staff at Stanford Hospital & Clinics and Lucile Packard Children’s Hospital from taking industry gifts of any size from pharmaceutical companies. Yet as the ProPublica data and previous investigations have shown, many Stanford affiliates continue to accept considerable sums of money. 

Not all drug companies have submitted their records of doctor interactions, according to ProPublica, the independent, non-profit organization of investigative reporters. Roughly about 40 percent of U.S. drug sales are represented by the companies that have.

Medical ethicists have claimed improprieties in the way companies try to manipulate doctors into recommending their products. However, many doctors argue that there is no ethical quandry in being paid to educate other doctors about the best drugs and the best ways to use them.

The ethicists say that drug company marketing can often trump science. According to a presentation by researcher E. Haavi Morreim to the Markulla Center for Applied Ethics at Santa Clara University, doctors were more prone to prescribe drugs that the companies have marketed to them, whether they knew it or not.

The paper, entitled "Prescribing Under the Influence," gave anecdotal and scientific evidence that doctors, like most consumers, can be consciously or unconsciously influenced by the power of marketing.

In one study, 71 percent of doctors were proven to have believed marketing over scientific evidence to the contrary, while others, taken on a lavish trip by a drug company, doubled and tripled their prescriptions for its products.

However, doctors argue that drug companies are spending hundreds of millions of dollars to research new drugs and have to teach doctors how best to use them, as well as using the best scientific field work to market them.

Santa Cruz's Dr. Yeh said he saw nothing wrong with taking money from GlaxoSmithKline for lecturing about its vaccines and drugs as long as his own research proved they were the best. He said he has a double PhD, including one in Pharmacology.

"As long as it is for medical education, there is no problem," he said. "If I were to take money from another drug company for the same thing, that would be a problem."

Yeh said that without such lectures, doctors would have trouble learning about the latest drugs.

Some doctors disagree. Dr. Daniel Carlat, a psychiatrist and Tufts University professor had taken $30,000 a year from pharmaceutical companies to talk about their products, but quit after his conscience began nagging, he told USA Today.

"My role in the company was not by any means to serve as a source of unbiased medical information," he told the newspaper. "But my role was really simply to be a part of their marketing machinery and that was the value I had for them."

Drug companies have paid for meals and lavish trips for doctors – all legally – and given them exhorbitant speaking fees, sometimes in places they would want to bring their families for vacations.

They have also stepped over the lines. GlaxoSmithKline paid a $3 billion settlement with the U.S. government over charges that it encouraged doctors to use drugs for purposes other than those for which they were approved and earned big money doing so.

Some hospitals and medical schools ban doctors from accepting gifts from drug reps, including the University of Pennsylvania, Yale University and Stanford University, according to USA Today.

-- with additonal reporting from Avni Nijhawan