1 in 4 MA Physicians Received Gifts From Big Pharma

Saturday, May 04, 2013

Ashley Klann, GoLocalWorcester Contributor

Numbers released from the state's Department of Health and Human Services has revealed that 1 out of 4 practicing MA physicians have taken gifts from major pharmaceutical companies.

Numbers have been collected in Massachusetts since 2009, and the latest compilation of data from the New England Journal of Medicine combines all years, up until 2011, showing changes in the size of gifts, type, and amount.

The state’s department keeps track of all gifts received by doctors for the amount of over $50, including food, education and training services, and other gifts, according to the 2009 Massachusetts Pharmaceutical and Medical Device Manufacturer Code of Conduct, which has required this reporting since July of that year.

25 percent of currently licensed Massachusetts physicians (8439 of 33,446) received at least one payment between July 2009 and December 2011. 32,227 reported payments and gifts were made since the law went into effect to 11,734 physicians in the Bay State, bringing the total to $76.7 million.

In 2010, a total of 6,530 physicians appeared in the database, as compared with 5,921 in 2011. The average total payment per physician over the course of a year increased slightly, from $4,637 in 2010 to $4,944 in 2011.

“Bona fide services,” are also a commonly listed reason for compensation and are defined as a range of activities the physician can provide for the company.

Specifically, these “bona fide services” can include but are not limited to research, participation on advisory boards, collaboration with organizations dedicated to the promotion of health and the prevention of disease, and presentations at pharmaceutical or medical device manufacturing company-sponsored medical education and training.

The Cost to Consumers

Deirdre Cummings, Legislative Director with MASSPIRG (the Massachusetts Public Interest Research Group) has said that big pharma’s gifting to doctors is hurting consumers and raising the price

“It’s a marketing strategy. The most typical gift is meals provided by the industry to physicians to talk about drugs. And there are other arrangements and hidden fees,” she said. “The cost to consumers comes as the drug reps market only the expensive, name brand drugs. The consumers pay for the meals and the drugs prescribed.”

Cummings also said the practice is bad for small businesses.

“It’s also bad for small businesses. Anything that increases the costs of health care is hyper problematic for small businesses that are struggling in this economy and trying to provide for employees,” she said.

The Worst Offenders

According to the state’s database, the most common form of payment was food, accounting for $2.4 million of the total gifted amount. The average cost for food to a Mass. physician was $100

Compensation for bona fide services was the payment type with the highest value. The 8,432 payments in this category accounted for $67.3 million statewide, or 88% of total expenditures.

Which physicians took the most in gifts? Primary care was among the specialties least likely to receive payments: the database contained payments to fewer nonspecialist internists (19%), pediatricians (12%), and family practitioners (21%) than urologists (61%), gastroenterologists (57%), rheumatologists (51%), and cardiologists (46%).

Central Mass Doctors Taking Gifts

In 2009 Physician Lawrence M. Dubuske of Gardner took gifts from Astrazeneca Pharmaceuticals, Novartis Pharmaceuticals, Schering Corporation, Smithkline Beecham D/B/A Glaxosmithkline, and Sunovion Pharmaceuticals, Inc. as compensation for bona fide services and food.

Dubuske took in the fifth most in gifts in the state, totaling out to $153,452.15.

Physician Dennis J. Rosen of Belchertown received $21,528 in gifts in compensation for bona fide services from Novartis Pharmaceuticals and $56,500 in food, education and training, bona fide services, and other gifts from Shire Phamaceuticals in the same year.

Worcester physician William Brian Balcom also made the list that year with $87,254.96
in compensation for Bona Fide Services from Exactech, Inc.

In 2010, Worcester physician Patrick J. Connolly received the third highest amount in gifts. Connolly received a total $281,692.00 in food and compensation for bona fide services from K2M, Inc.

Dr. Rosen made the list again that year, with gifts from the same two companies. That year, he took in $165,181.67 in compensation for services, food, education and training, and other gifts.

Framingham physician, William P. Castelli received gifts from Abbott Laboratories,
Smithkline Beecham D/B/A Glaxosmithkline, Takeda Pharmaceuticals America, Inc., and Takeda Pharmaceuticals America, Inc. including food, services, grants and educational gifts and other expenses.

His total came to $149,635.91.

In 2011, Dr. Dubuske made the top of the list, with the fourth highest amount received in gifts. The Gardner physician cashed in with a total $294,777.44 in gifts for services, food, and education and training. Astrazeneca Pharmaceuticals paid out the most, followed by Covidien-Medical Supplies, Merck & Co. Inc., Novartis Pharmaceuticals, Smithkline Beecham D/B/A Glaxosmithkline (Gsk), and Sunovion Pharmaceuticals, Inc.

Physician Amjad Bahnassi of Worcester also made the list, with $139,648.81 in gifts and compensations from seven different pharma companies, including Bristol-Myers Squibb Company.

Worcester’s Ajay K Wakhloo, another physician, received gifts from Codman & Shurtleff, Inc., Covidien-Vascular Therapies, Depuy Spine, Inc, and Stryker Corporation, making $99,036.88 in compensations for services and food.

Another Worcester physician made the list, Brian D Busconi, who received gifts from Depuy Mitek, Inc. and Ferring Pharmaceuticals Inc. From those two companies alone, he received $98,616.00 in compensation for bona fide services and education and training.

Data Trends

Overall the numbers revealed that between 2010 and 2011, relationships between pharma companies and physicians became more profitable. The New England Journal of Medicine reported a slight increase in the average payment amount, yet fewer physicians received payments from drug and device companies.

One reason the journal gave to this trend was the high proportion of physicians in the Commonwealth who are affiliated with academic medical centers that have policies preventing doctors from accepting types of gifts – such as UMass Memorial Medial Hospital in Worcester.