Central MA Doctors Paid Millions By Pharmaceutical Companies

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Tuesday, February 28, 2012

GoLocalWorcester News Team and Jaclyn Cashman, News Editor

Doctors in Worcester and across Central Massachusetts are collecting millions in payments from drug companies. One of these physicians has earned more than $500,000. The top 30 physicians collected more than $2 million in fees and payments.

The relationship between physicians and drug companies has come under greater scrutiny in the past few years. In some cases, local doctors are earning tens of thousands of dollars from drug companies and the relationship is undisclosed to their patients.

These payments from drug companies to physicians are listed primarily for research, consulting, travel, meals, and speaking.

As required in the “Sunshine” provisions of the recently passed federal, Patient Protection and Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) is required to publish “transparency reports” that disclose these industry payments of drug companies to doctors.  Recently, CMS proposed strict restrictions against drug company payments to physicians and requirements for strict reporting. Violations of reporting requirements vary and would include up to a $1 million fine.

In Massachusetts, total payments from drug companies to physicians totaled more than $22 million.

Speaking Fees – What is Reasonable

One local physician, Dr. Amjad Bahnassi, a Worcester-based Psychiatrist, has earned more than $125,790, primarily in speaking fees from drug companies such as Novartis, AstraZenica, Pfizer, and GlaxoSmithKline. GoLocalWorcester's calls to Dr. Bahnassi went unanswered.

The Mass Medical Society has policies directing physicians on how to handle gifts, free drug samples for their family members and travel to conferences.

The Medical Society specifically allows speaking fees if they are “reasonable.” In full the policy states, “It is appropriate for faculty at conferences or meetings to accept reasonable honoraria and to accept reimbursement for reasonable travel, lodging, and meal expenses.”

When asked if it was reasonable for one physician to receive more than $125,000 from four drug companies, Mass Medical Society’s Rick Gulla said, “I can’t answer that (if it is reasonable). It depends on what the physician was asked to do. It’s a question best put to the companies and the doctor. What’s reasonable to one person may not be reasonable to another.”

The Biggest Winners

According to data collected by ProPublica the independent, non-profit newsroom that produces investigative journalism in the public interest, these payments are largely unreported to the public.

Dr. Anthony Puopolo of Milford Emergency Associates, Inc., has received more than $528,000 from GlaxoSmithKiline. Repeated efforts to reach Puopolo were unsuccessful.

The second highest recipient of pharmaceutical payments was Dr. Charles Birbara who strongly defended the payments he receives. Birbara, who has received more than $265,000, told GoLocalWorcester, “We help advance the science of medicine. Without the clinical trials that we do no new medications would come to the marketplace. We make sure medications work properly.

According to Dr. Birbara, he and his team helped bring the drug- Humira (a rheumatoid arthritis drug) to the marketplace along with other medications to treat pain and osteoporosis.
“Pharmaceutical companies have new medications and they want to see if these medications have side effects before they get to the market. Our work is reviewed by the FDA. I have played a major role in bringing some major drugs to the marketplace. I figure out what side effects drugs have. I have nine people working for me doing these clinical trials.”

Which Companies Paid the Most?

According to GoLocalWorcester’s review of the numbers, GlaxoSmithKline paid physicians more than $1,021,000 – three times the nearest competitive drug company. Eli Lilly paid $305,816 to physicians from everything from research to speaking engagements. The other six-figure spender is AstraZeneca, totaling $141,640.

Local Hospitals Mixed Policies

Many local hospital groups restrict their physicians from accepting any payments from pharmaceutical companies. St. Vincent Hospital/Vanguard Healthcare’s Dennis Irish wrote in an email to GoLocalWorcester, that payments from drug companies are prohibited. “Vanguard’s Corporate Code of Conduct and Compliance Policies expressly caution that payments to employees that are intended to influence someone’s judgment must not be accepted.”

Similarly, UMass Memorial Medical Center restricts payments from drug companies to physicians, but that policy does not carry to the rest of their system, “The UMass Memorial policy is a UMass Memorial Medical Center policy…only covers the Medical Center, not the entire Health Care system,” Robert Brogna, Manager of Media and Public Relations at UMass Memorial Medical Center.

"Our policies prohibit any employee from taking anything that might create the impression there was a possible conflict of interest," said Irish.

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