Drug companies' reports aren't always accurate

[Guest guest]

http://www.startribune.com/business/111704609.html?elr=KArks:DCiU1OiP:DiiUiD3aPc:_Yyc:aULPQL7PQLanchO7DiUr

Drug companies' reports aren't always accurate

A new federal plan will require drug and medical

device companies to report all payments to U.S. physicians in

2013. The danger? As Minnesota found, some information may be

incorrect.

By CHARLES ORNSTEIN and TRACY WEBER,

ProPublica

Last update: December 12, 2010 - 4:49 PM

Long before the rest of the country cared, Minnesota took aim

at the pharmaceutical industry.

In 1993 it passed a novel law: If drug companies paid any of

the state's health providers to push their pills, the money

had to be publicly reported.

Two decades later, the federal government is poised to follow

suit, promising a new era of openness.

But a ProPublica analysis of drug company disclosures in

Minnesota provides a cautionary lesson: The information

submitted may not be accurate.

To vet Minnesota's reports, ProPublica compared them to its

Dollars for Docs database, a compilation of speaking fees and

consulting payments reported by seven drug companies since

2009.

Cases like that of St. pain specialist Todd Hess turned

up. Minnesota's website shows that Hess received $364,828 last

year from four companies -- far more money than any other

physician.

But that understated what at least one of the companies

reported on its own website. Eli Lilly and Co. told Minnesota

it had paid Hess $67,353 in 2009 to give speeches in favor of

its pain pill Cymbalta. On its website, however, the company

reported paying Hess $74,050.

The Minnesota official charged with overseeing the data said

he hadn't known about the discrepancy -- and wouldn't unless

someone flagged him. The Minnesota law provided no resources

to audit their accuracy, said Cody Wiberg, executive director

of the state pharmacy board, which collects the information.

Experts who study physician-industry relationships say the

accuracy of this information is important. Based on the

disclosures, patients or employers may wrongly believe a

physician has greater, or lesser, ties to a drug company.

ProPublica found multiple other examples.

Pfizer, for example, told Minnesota that it paid Dr. Randy

Schapiro $1,770 last year. But on its website, Pfizer reported

spending $43,827 on him in the second half of 2009 alone.

And Wyeth, now a Pfizer subsidiary, reported payments to

individual doctors that actually went to their institutions

for clinical research. It reported paying $500,000 to

transplant surgeon Arthur Matas, for example, when the money

really went to the University of Minnesota, according to

Matas.

Minnesota records show that Matas personally received just

$6,190 in 2009 -- for consulting for Bristol-Myers Squibb and

speaking to the Mexican National Transplant Congress on behalf

of Genzyme.

Representatives of Wyeth, Pfizer and Lilly said they were

unaware that their reports contradicted one another until

contacted by ProPublica.

Wyeth submitted a revised report to Minnesota removing Matas

and more than a dozen other physicians because the payments

did not go to them personally. Pfizer has submitted a revised

report listing Schapiro's pay last year as $96,889 -- more

than 50 times what it initially said. A Pfizer spokeswoman

said her company found internal problems that led to the

inaccurate report. A Lilly spokesman said his company also

would amend its Minnesota report.

Doctors respond

Hess and Schapiro, like other Minnesota physicians

interviewed, said they were unaware of the discrepancies and

hadn't looked at the latest disclosures. They said the media

make a bigger deal about potential conflicts of interest than

patients do.

"If it's cleaned up, then I don't personally have any

problems with people seeing the numbers," said Schapiro. A

specialist in multiple sclerosis, he is now retired and living

in Colorado but still does speaking and consulting.

Schapiro said the doctors paid by pharmaceutical companies

are "leaders in their fields," and patients should want to see

their physician among them. "If their doctor is not on the

list," he said, "maybe they should look for a different

doctor."

Hess, the St. pain physician, said his patients aren't

concerned about his speaking fees. The media is lumping

together educational speaking with the excesses of the past,

he said, when drug companies showered physicians with gifts

and free trips. "This is a mountain-molehill thing," he said.

"I know the problems of the past. I know what Pharma has done

to change those."

Pitched battle

Minnesota's experiment began in the early 1990s as an answer

to complaints to the state attorney general.

Patients were calling, concerned that their doctors were

steering them to high-cost medications. Physicians were

reporting pressure from the pharmaceutical companies and the

"bonanza" of trips, fancy dinners and other inducements,

recalled Matt Entenza, then an assistant attorney general and

later a legislator.

After a pitched battle with industry lobbyists and

physicians, the Legislature adopted the disclosure plan.

Years later, however, lawmakers learned that the drug company

reports had been simply filed away. Only after researchers and

others pressed to see them were they put on the website of the

state's pharmacy board in 2006.

Wiberg, the board's executive director, said his agency

was an unusual choice as the home of the disclosures. The

pharmacy board oversees drugs, pharmacies and pharmacists,

not money or physicians.

Today, the state posts reports covering about 900

physicians, nurse practitioners, physician assistants and

veterinarians, and includes payments from companies of

every size. It does not put them in a searchable database,

however, and requires users to click through the

individual reports of 80 companies to find their doctors.

ProPublica has combined Minnesota's 2009 reports into one

database.

The federal law, known as the Physician Payments Sunshine

Act, is more expansive than Minnesota's effort in some

respects. The act covers both drug companies and medical

device manufacturers, while Minnesota's law is limited to

pharmaceuticals. It also calls for a searchable database,

which will make looking up a doctor easier.

But as in Minnesota, the federal law does not require

auditing. It does allow for fines if a company reports

incorrectly or not at all.

Dr. ph Ross, an assistant professor of medicine at

Yale School of Medicine who has studied Minnesota's

disclosure law, said he was surprised to learn of the

discrepancies. He said the companies are quickly learning

that there's an intense interest in how much they pay

physicians.

"You just hope that going forward they do a better job,"

he said.

ProPublica is an independent, nonprofit newsroom in New

York City that produces investigative journalism in the

public interest.