Mass. Posts Industry Payments to Health Care Providers
By Liz Kowalczyk of The Boston Globe, www.boston.com
Massachusetts health officials published online today the most comprehensive state database in the country listing payments drug companies and medical device makers made to hospitals, doctors, nurses, pharmacists, and other health care providers in the state.
The report lists $35.7 million in payments from hundreds of companies for the six months between July 1 and Dec. 31, 2009, for speaking, consulting, food, educational programs, marketing studies, as well as charitable donations. Nearly half of that money — $16.4 million — went to physicians.
This is the first time Massachusetts has made such information public. Any drug or device company doing business in the state was required to begin reporting certain payments of $50 or more, under a law passed two years ago that also bans the companies from providing gifts to physicians and limits when they can pay for doctors’ meals. Companies don’t have to disclose funding for research aimed at answering a legitimate scientific question, but do have to report payments for marketing studies that are designed to promote a product. The database includes payments from 283 companies.
The public can search the database at mass.gov/dph/pharmamed, as well as read state Department of Public Health analyses of the information.
Industry payments to physicians have come under increasing scrutiny because of critics’ concerns that the money influences doctors to prescribe newer and more expensive medications, helping to drive up the cost of health care. But the companies and many doctors say that physicians should work closely with drug and device companies to help develop new treatments and educate their colleagues — and that it’s only fair they be paid for their time.
A number of other states require companies to disclose certain payments to medical providers, but it is not possible to compare the amount and number of payments made to Massachusetts providers to those in other states, because no other state is publicly reporting payments in such detail. A growing number of pharmaceutical and device companies — some as part of settlements with federal prosecutors investigating inappropriate marketing — have started listing money paid to physicians on their websites, but they do so for a limited number of categories.
The physician receiving the most during the six-month period, according to a DPH analysis, is Dr. Mary Ann Asbell in Cambridge, who was paid $194,275 by Genzyme Corp. in Cambridge for unspecified “bona fide services”, a category that includes speakers bureaus and consulting. However, she is not listed currently as a licensed doctor in Massachusetts, according to the Board of Registration in Medicine.
The other top four doctors were Dr. Charles M. Gibson, a Boston cardiologist paid $188,617 by six companies; Dr. Stephen John Ferzoco, a general surgeon affiliated with Brigham and Women’s Hospital, paid $187,443 by Lifecell Corp. of New Jersey; Dr. Lawrence M. Dubuske, a former Brigham allergist, paid $153,385 by five companies; and Dr. Stephen B. Murphy, an orthopedic surgeon affiliated with Beth Israel Deaconess Medical Center, paid $149,996 by Wright Medical Technology of Tennessee. More than 5,000 doctors received payments.
After doctors, registered nurses received the next most money, $1.2 million, followed by pharmacists, $623,360, and dentists, $516,656.
Compensation for participating in speakers bureaus, consulting, and other “bona fide services” was by far the largest category of payments, accounting for almost $18 million.
Consulting with industry to develop new treatments is considered part of a physician’s role. But participating in speakers bureaus is controversial. Bureau speakers typically show groups of doctors company-created or approved slide presentations about specific drugs or diseases treated by a company’s products. Many of these talks, often held at fancy restaurants, have been moved out of state since last year, when Massachusetts banned doctors from eating the free dinners. Companies defend speakers bureaus as an important tool for educating doctors.
Elizabeth Daake, policy and planning director for the state’s Bureau of Health Care Safety and Quality, said that since the disclosure requirement is new she wasn’t sure what to expect in terms of the amount and types of payments. But she said this first database gives the state a baseline that will allow it to measure the impact of the growing number of hospital and medical school policies banning certain industry payments to health care providers. Many institutions are cracking down on doctors’ relationships with companies for fear they can create bias, or at least the perception of bias, when it comes to prescribing drugs or recommending treatments.
“It will be really interesting to see what this shows going forward,” Daake said. “I wouldn’t be at all surprised if we see a decline (in payments). Public reporting itself draws attention to it.”
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