Doctors and Drug Company Money

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5min 21sec

Colorado Public Radio has learned that many doctors here get paid by drug companies, but don’t report it as required by state law.

Colorado is the only state in the nation where doctors have to disclose this outside money. It’s all supposed to be posted on a state-run website of “physician profiles” - but many patients would come up empty-handed if they went there to check their doctor’s financial relationships.

Colorado Public Radio Health Reporter Eric Whitney has the story.

Learn More:

Look for your doctor in the State of Colorado's "Physician Profiles" database.

See more stories on this topic from NPR, and search ProPublica's database to see if your doctor is getting drug company money.

This story was produced with the assistance of the Rocky Mountain Investigative News Network.

Transcript of the story:

Whitney: Aurora Senator Morgan Carroll led the fight to require doctors to disclose whether they are getting paid by drug companies. She says it’s crucial patients have that information.

Carroll: If your paycheck is hinging on pushing a brand name drug, I think it becomes less likely that you're able to speak candidly about problems in research about the drugs, about cheaper alternatives, about better alternatives.

Whitney: So in 2007 Senator Carrol got a law passed that requires every Colorado doctor to disclose on their public profiles whether they're working for drug companies. But it’s not working like it’s supposed to.

We learned that at least 130 Colorado doctors were paid significant money by drug companies last year. When we checked on those -- two-thirds had failed to disclose the income as required by state llaw.

Now, drug companies generally don’t make public which doctors they are paying. The only way we have that information is because the national investigative reporting group ProPublica did some digging. They were able to get records from 7 drug companies, mostly the result of legal cases the companies had settled.

The Department of Regulatory Agencies, or DORA, oversees Colorado’s physician database. They weren’t aware that 84 doctors weren’t complying until we brought it to their attention. Teresa Pella is with DORA.

Pella: This is a program that we need to rely heavily on others to help us ensure that there's compliance with the profiling system. And what we will be doing is sending what we call letters of inquiry out to each of the physicians that you had identified.

Whitney: Those letters went out last week, and a number of doctors have already updated their financial disclosure information based on our inquiry. Doctors who fail to disclose face fines and potential action by the state medical board.

Pella says state regulators don't have the resources to audit physicians. And even if they did, here’s the thing - the companies that give doctors money? They don’t have to disclose it. So if a doctor’s profile says he’s not getting outside money, there’s no way to cross check that.
The ProPublica database that we used to check on Colorado doctors is brand new, and offers just a glimpse - it only contains disclosures from a fraction of drug companies.

So there's still no way to tell exactly how many of Colorado's 18-thousand doctors get paid by drug manufacturers.

But we have reason to believe most Colorado doctors who get that money aren't disclosing as required.

Dr. Benjamin Young.

Young: I’m not aware of the specific statute, uh, and perhaps should be.

Whitney: Dr. Young made $75,000 last year working for drug companies. He says he just didn't know he was supposed to report the income. We tried to reach more than 40 doctors, most of whom had not disclosed. Only a handful agreed to talk. They, and others in the medical community and even the state agency, DORA, agree that the issue is that doctors are just unaware of the 3-year-old law.

But all the doctors we spoke to, like Dr. Young, say they support the financial disclosure requirement.

Young: I would welcome that. Moreover, any time I speak in public, whether it is sponsored by pharmaceutical companies or a university, I fully disclose my financial relationships.

Whitney: And doctors say it isn’t necessarily an ethical compromise to accept money from drug companies - Dr. Young’s payments go straight to his non-profit HIV clinic.

Bruce Morgenstern is a Denver neurologist who drugmaker Eli Lilly paid $75,000 last year.

Morgenstern: (sigh) it sounds intuitive, like, gee, if the drug company pays a doctor a lot of money he’ll use the drug, kind of like a bribe. It really isn’t true.

Whitney: Morgenstern and other physicians say good doctors can steer clear of bias. Dr. Michael Pramenko is president of the Colorado Medical Society, the state’s largest physician’s organization. He says the relationships can be beneficial.

Pramenko: Some doctors are providing very useful information to other doctors on new medications, on their appropriate use, when to use them, and maybe when not to use them. As long as there‘s some transparency they are being financed in part by that pharmaceutical company, it’s that transparency that’s important.

Whitney: That transparency will increase under the federal health reform law. Starting in 2013, all drug manufacturers will be required to report the names of doctors they pay.
In Colorado, that means that for the first time people will be able to check the accuracy of what physicians are disclosing.

First, though, state regulators are looking for better ways to let doctors know about the requirement.

Senator Carrol says she’ll go to the legislature for changes in the law if that’s what it takes get doctors to reveal information patients have a legal right to know.

Eric Whitney, Colorado Public Radio News.