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Spotlight begins to shine on link between drug companies and doctors

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Prescription medications.
MPR Photo/Lorna Benson

The documents offer a rare glimpse into the financial relationship between drug companies and doctors.  Minnesota is one of only five states that require disclosure of drug company payments. 

The law requires reports on payments of $100 or more for things such as speaking fees, education expenses, travel and other consulting expenses.  News of the size of the payments has created quite a conversation among some Minnesota doctors.   

"This is something that we're generally not very happy about," says Peter Weissmann, a professor of internal medicine at the University of Minnesota and a doctor at Hennepin County Medical Center.  

Weissmann, who has not received any payments from drug companies, says he and his colleagues at HCMC are concerned that the money is influencing medical decisions.  

"Doctors don't have time to listen to drug salesman, and most do everything they can to avoid them."

"I gotta believe that organizations as sophisticated as pharmaceutical companies, which are extremely profitable, would not be spending millions of dollars if that outlay of cash didn't have any effect," says Weissmann.

Weissmann says he'd like to see better disclosure requirements, so the public knows whether a doctor is receiving a significant amount of money from a drug company.  He suggested putting all of the information on a Web site so it's available to the public. 

The Minnesota Board of Pharmacy, which collects the data, says it will look at putting the information on the Internet. But, for now, it isn't easy to sort through.  

When MPR first started going through the documents last fall, thousands of pages of documents were stored in cardboard boxes and put in the corner of an office. The documents vary in detail.  Some companies specified their contributions.  Others didn't detail the payments at all.  

Some of the doctors who received some of the larger payments did not return calls for this report.

Richard Geier, president of the Minnesota Medical Association, downplays the significance of the payments.  He says some of the contributions were made to academic medical centers and other institutions for research purposes.  

Geier also says he didn't think speaker fees or other payments influenced medical decisions.

"What they're really doing when they buy dinner for a doctor is to get a doctor to sit down and listen to their pitch. They're not trying to bribe him to prescribe their brand over another brand," says Geier. "Doctors don't have time to listen to drug salesman, and most do everything they can to avoid them."

Geier wouldn't say if he would support greater disclosure of the information because he doesn't know enough about the law.  

Peter Lurie prepared the Public Citizen report.  He said the state law isn't effective because the documents are hard for people to interpret.  He also says the state should enforce the law better.   

"Many [drug companies] state that they have given millions of dollars in one year, yet somehow report absolutely nothing in the next.  The state makes no effort whatsoever to follow up with those who don't report," Lurie says.

Lurie says he's concerned that the documents show only a fraction of the drug company contributions.  He, like others, worry about the influence the payments have on physicians. 

But Marjorie Powell, with the Pharmaceutical Research and Manufacturers of America, says the reports are misleading because they include both contributions to research and payments to doctors.   

Powell also says pharmaceutical companies aren't trying to influence doctors, but are trying to educate them on a specific drug.

"They aren't just trying to sell medicine.  They're trying to make sure that the medicines, when they're prescribed, are the right medicine for that patient and for that condition," says Powell.

Powell says she would like to see state lawmakers change the law so research funding is separate from other contributions.  

Cody Wiberg, executive director of the Minnesota Board of Pharmacy, says he's working to better enforce the law already on the books.  He says the issue wasn't a high priority when he was first hired in 2005.  

"Prior to September of 2005, the board didn't do a whole lot with this data.  Since then, we have been doing quite a bit more with the data and have plans to do even more yet," says Wiberg.

Wiberg says he's looking at the documents to see whether any of the payments violate a state law.  Drug companies are not allowed to give gifts, including meals, of more than $50 a year to doctors.  Wiberg says companies that continue to violate that law could receive fines of up to $10,000 for each violation.  

Sen. Linda Berglin, DFL-Minneapolis, says she may consider changing the law so drug companies have to provide more information on physician payments.  She says she'll talk with Wiberg to see what needs to be done to improve the reporting system.