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November 10, 2010
 
In This Issue
From the Director
ProPublica Data on Payments to Docs
Senate Objections to Ending Pay-for-Delay
Pharma Watch - Around the Web
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From the Director
Executive Director 
To our Readers:
This is the first issue of our revamped newsletter.  We are now providing original articles about emerging policy issues and best practices, with a continued focus on state policy and prescription drug prices and access, and links to key articles published in the past two weeks.

This first issue highlights newly compiled information about physicians' conflicts of interest and the battle in Congress over generic drug-related pay-for-delay legislation.  In addition to this biweekly newsletter, we will share breaking news stories and interesting ideas through our Blog and Facebook page, so be sure to subscribe to both.  I hope you like the changes, and feel free to provide feedback and future story ideas! Sincerely,
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The Pro-Publica Treasure Trove: Payments to Physicians and Why Conflict-of-Interest Policies, Gift Bans, and Sunshine Laws Matter 

ProPublica, a center for journalism in the public interest, launched their Dollars for Docs program last month.  The ongoing investigation includes a searchable database that includes 17,000 U.S. doctors and allows their patients to search to determine whether their physician has taken money from the pharma industry.    The ProPublica site includes ongoing analysis and opinion articles, including articles from partners NPR, the Chicago Tribune, the Boston Globe, Consumer Reports, and PBS. 

One area of specific interest to state legislators is the ability to break down payments to physicians by state and to see which pharmaceutical manufacturers are the biggest spenders for state docs.  The data show that California, New York, Texas, Florida, and Pennsylvania top the list of payments to physicians.  Because aggregate payments are shown, more populous states would be expected to top the list, but data on comparable states is also useful to state legislators.

The ProPublica investigation reaches into many aspects of the industry payments to physicians.  These data has spurred a new wave into the investigation of the relationships between physicians and the pharmaceutical industry.  Following is a round-up of noteworthy articles and commentary on specific aspects of the recent coverage.

Payments to physicians who have been subject to professional sanctions

ProPublica: Docs on Pharma Payroll Have Blemished Records, Limited Credentials

Forbes: The Best Bits Of ProPublica's Pharma Payroll Investigation

HealthWatch: Big Pharma paying docs with dubious records to promote drugs

Medical Marketing and Media: Report says pharmas pay quacks to hawk drugs

Failures of conflict of interest policies and physician attitudes towards payments

The Boston Globe: Prescription for Prestige: Drug firms' speaking fees flow to Harvard doctors; concerns about influence prompt new restrictions

Hooked Blog: Review Time: Rationalizations Doctors Tell about Pharma Money

Hooked Blog: From ProPublica: The Seamy Side of Pharma Speakers' Bureaus

PBS: Pharma & Physicians

Payments to physicians and other marketing drives up costs by increasing the overprescribing of brand-name drugs.

NPR: How to Win Doctors and Influence Prescriptions

Sentinel/Source: Prescription Conflicts: Doctors Draw a Second Income from Drug Companies

Analysis and criticism of the project:

Carlat Psychiatry Blog ProPublica's Dollars for Docs Website

Scientific American How much money was your doctor paid by a drug company?

PostScript Blog Money and misconduct in drug company talks: early sunshine from ProPublica

How to use the Dollars for Docs Database for Patients

ProPublica: How Patients Can Use This Data

Consumer Reports: Consumers wary of doctors who take drug-company dollars

How to use the Dollars for Docs Database for Reporters and Advocates

Columbia Journalism Review: How to Use ProPublica's "Dollars for Docs" Database: Tips for reporters and editors

State-by-State Analysis of the ProPublica Results

NJ.com: Drug companies paid N.J. doctors millions to promote their products

Syracuse.com: Drug makers pay 51 Central New York doctors nearly $1 million to talk about their products

The Baltimore Sun: HealthKey: Database details pharmaceutical payments to doctors

Denver ABC 7: Report: Colorado Doctors Getting Thousands From Drug Companies

KUOW.org: Washington Doctors On Drug Company Payrolls

Cleveland.com: ProPublica database reveals Ohio, national docs relationships with big pharma

Senate Members Object to Pay-for-Delay Ban's Inclusion in the 2011 Appropriations Bill: Pay-for-Delay iis Good for Big Pharma, Good for the Generics Industry, but Bad for Patients and the Health Care System 

 

Even though generic drugs are an important tool for patients to afford their medicines, and for state prescription assistance programs to balance their budgets, both Republicans and Democrats in the Senate express continued opposition to legislative restrictions on the pharmaceutical patent settlements.  While these settlements are vehemently opposed by the FTC and delay access to affordable generics, federal legislators face strong pressure from home-state drug manufacturers to protect the practice. The inclusion of the "Preserve Access to Affordable Generics Act" in the 2011 Appropriations Bill has prompted members of both parties to petition Senate Majority Leader Harry Reid for its removal. That Act would make compensated patent settlements presumptively anticompetitive with a requirement of "clear and convincing evidence that the precompetitive benefits of the agreement outweigh the anticompetitive effects of the agreement."

Five Democrats submitted a letter to the Majority Leader on October 21, expressing their opposition, citing "substantive concerns with the content of these provisions," and claiming that the inclusion "contradicts both the spirit and letter of the Senate rules." It should come as no surprise that all five come from states that contain a large pharmaceutical industry presence. The rhetoric from the Republican camp has been equally biting. A similar letter from September 17 signed by four senators expressed "vigorous objection" to its inclusion on the argument that the Act grants excessive power to the FTC and would "do serious violence" to processes under the Hatch-Waxman Act. Most likely in reference to the Watson Pharmaceutical controversy, the Republican senators say that past events already show that the FTC cannot wield such power "in a responsible or economically rational manner."

FTC commissioner Jon Leibowitz sounded neither surprised nor demoralized in a recent interview with Ed Silverman at Pharmalot about the response. His attitude towards the legislative opposition is simply that "[w]e're going to get this done ... When their might is combined - the political capital and the pr machines - (the industry) has an awfully big megaphone." He did express continued optimism in chances that the Supreme Court will decide to hear this issue, even while declining to make specific timeline predictions beyond "we're closer than we were a year ago."

Pharma Watch - Around the Web
PhRMA Pushes Back Against Campaign Calls For Medicare Part D Price Negotiation read more at Kaiser Health News
Dueling Letters On Medicare Part D Changes read more at Kaiser Health News
Drug Payment Database Spurs Local Reports read more at Kaiser Health News
Glaxo To Pay $750 Million For Sale Of Bad Products read more at the New York Times
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