The independent nonprofit newsroom ProPublica assembled a searchable online database called "Dollars for Docs" on the belief that patients have a right to know whether their physicians are tied to particular drug companies. Inside, I-Team stories, links and information on Nevada doctors.More>>
LAS VEGAS -- The average American has four or more drug prescriptions. It amounts to the highest per capita prescription drug use in the world and 80 percent higher than it was in 1990.
It's no coincidence that more Americans are killed by prescription medicines than die in auto accidents. Drug companies spend hundreds of millions of dollars each year to make sure doctors keep writing prescriptions. Critics say, payments to doctors are a form of kickbacks and have nothing to do with the health of patients.
American doctors wrote more than 4 billion prescriptions last year. That's 13 prescriptions for every man woman and child. The growth in prescription drugs is finally starting to slow down, so drug companies -- which earned a stunning $830 billion last year -- are doing whatever they can to keep those prescription pads humming and to keep the pockets of your doctor filled.
Health journalist and radio host Bill Sardi has battled big pharma for 20 years. His company markets a promising natural supplement containing Resveratrol, which the drug companies have tried to belittle, he said, because it is cheaper and more effective than prescription meds.
Americans are the most pill happy people on earth, largely because marketing campaigns by drug companies have successfully targeted consumers and doctors, but it comes at a steep price.
"Over 100,000 die every year from properly prescribed drugs in hospitals. That's not the ones outside where people can misuse them. The Vioxx scandal killed thousands. The FDA hid the whole thing until a whistle blower in their organization disclosed it," Sardi said.
Direct kickbacks to doctors are illegal, so drug companies, and medical supply firms which make things like surgical screws, have found increasingly creative ways to put money into doctors' pockets. This quid pro quo often has little to do with patient needs.
"We have pharmaceutical representatives coming into the office, peddling drugs that are not better than the older drugs because they went off patent and you can't make blockbuster money on it. They call them blockbuster drugs. We are now using drugs that don't work as well. The only way they can hang onto the business is to buy off the doctors. The problem is, everybody is now in on it. Everybody," Sardi said.
"And the money has been really sort of astonishing," said Tracy Weber of the non-profit journalism organization Pro Publica.
She helped compile a database that is the first quantifiable glimpse into the murky world of big pharma payments to doctors. The database is admittedly incomplete because the industry doesn't give out such information voluntarily, but the numbers for a three-year period are jaw dropping.
"We have payments stretching back to 2009 and there's $2 billion in payments for such things. It's accounted for 2 million payments and some of the physicians receive astonishing amounts. One doctor has received over $1 million in speaking and consulting fees. We know that physician gets it from other companies, as well, that are not in our database. We wonder how is a physician able to do his job when he is receiving so much money on behalf of the drug?" Weber said.
The only reason Pro Publica was able to get financial records from 15 major drug companies is because those firms were charged with crimes by federal authorities. Drug and medical supply companies spend hundreds of millions per year to influence medical providers. They provide gifts to doctors, free samples, lavish meals and entertainment, speaking fees for speeches written by the drug companies, first class travel to exotic destinations, or sign up doctors as "consultants." The reason they spend so much is because it works.
"Ninety-four percent of doctors have some affiliation with a drug company or a medical device company. I know from various research studies that doctors are influenced by such things you just mentioned, gifts, speaking fees, honorariums. Drug companies are not stupid. They are not going to be doing this if they don't think it helps the bottom line," said Dr. Leana Wen.
"Drug company sales reps keep in their hands the exact numbers of how much drugs the doctors each prescribe, and they are always trying to move the needle to get the doctors to prescribe more of their drugs," Tracy added.
In the last few years, companies have paid billions to settle kickback lawsuits in which they encouraged doctors to prescribe drugs for unapproved uses. Two weeks ago, Johnson and Johnson paid a whopping $2.2 billion because its sales force gave kickbacks to doctors and nursing homes to dispense drugs that proved harmful to children, seniors, and the disabled.
In October, Omnicare paid $120 million because of kickbacks paid to the nation's largest nursing home pharmacy. Eli Lilly paid $1.4 billion in fines after its sales force "disregarded the law." GlaxoSmithKline reached a $3 billion settlement for coaxing doctors into prescribing Paxil for unapproved uses.
The list of settlements is long, and many hit close to home. A Nevada medical device company was fined $30 million for paying doctors what amounted to bribes, including first-class travel for doctors' mistresses. A Swiss company Novartis gave doctors trips to lavish Las Vegas resorts or fishing excursions. Aggressive marketing not only put patient's health at risk but caused millions in false claims being submitted to public health programs.
Doctor Leana Wen and a few colleagues have started a disclosure movement, to let patients know whether their doctor is taking money, how much, and from whom? But she's already run into considerable resistance.
"Initially doctors are not very happy about this because they do not like to disclose to their patients. They have all kinds of responses including 'it's none of my patient's business or it doesn't impact my prescription habits,' but we know from research that it does. The people that are getting tens of thousands, hundreds of thousands of dollars, they are not going to be so easy to convince, right?"
In 2014, a sunshine law takes effect which will require companies to make public all the money they funnel to medical providers, so we will finally see just how many millions have been lavished on doctors and others. The biggest chunk of money is labeled as research. Is the research being done here in Nevada legitimate, or another form of under-the-table payments?
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