Biogen, a pharmaceutical company that markets half a dozen MS therapies, is accused of paying doctors to prescribe its medications.
A former Biogen employee claimed that the company paid fake consulting and speaking fees to doctors who prescribed Avonex (interferon beta-1a) and Tysabri (natalizumab) in 2009 and 2010. The company now faces a False Claims Act lawsuit in Massachusetts. Biogen also markets Fampyra (fampridine), Plegridy (peginterferon beta-1a), Tecfidera (dimethyl fumarate), and Zinbryta (daclizumab).
The e-letter Law360 reports that Biogen has claimed that there’s no evidence a payment was made to any specific doctor in exchange for prescribing one of its treatments, or that any doctor changed the medications they prescribed after being paid by Biogen to be a consultant or a speaker.
How much do doctors make when they consult, research, etc.?
This got me wondering how much extra cash doctors, particularly those who prescribe MS treatments, are legitimately receiving from pharma companies. So, I turned to the Centers for Medicare & Medicaid Service’s Open Payments website.
Open Payments describes itself as “a national transparency program that collects and publishes information about financial relationships between the health care industry (i.e. drug and device companies) and providers (i.e. physicians and teaching hospitals).”
In other words, the website shines a spotlight on the checks that Big Pharma is writing to doctors for things such as research, consulting, and speaker fees. Also, meals, travel, and gifts. On the website, you’ll find a tool that allows you to follow the money. You can search for physicians and teaching hospitals receiving payments, as well as the pharmaceutical companies that have made those payments. Presently, it covers 2013 to 2016, but data from 2017 is due to be uploaded on June 30.
Searching through Open Payments
According to the Open Payments database, about 631,000 doctors in the U.S. received a total of $2.06 billion in payments from 1,479 pharma companies in 2016. It shows that the mean general payment for doctors in a category that includes neurologists — allopathic and osteopathic physicians in psychiatry and neurology — was about $8,400. (The mean general payment for all physicians in the database was just under $3,300.) But some are making a LOT more. Here’s an example of one neurologist who received a total of $424,690.70 from half a dozen pharmaceutical companies in 2016. According to the website, that doctor was paid an additional $600,000 in connection with research projects. (Screenshots via Open Payments.)
You can also click on a tab to see which pharmaceutical companies made those payments to that doctor:
And, on another page you can see the total amount of payments made by any pharmaceutical company to all doctors and research hospitals in one year. Yes, what you see below is over $49 million that Biogen paid in 2016.
Quid pro quo?
I’m not suggesting that there is any connection between these payments and the treatments that doctors prescribe. I know a number of neurologists who have been on the medication lecture circuit for years. They speak to groups of MS patients who are considering using a particular treatment, or they teach other medical professionals about that medication. The physicians I know who do this are excellent, experienced specialists whose time is valuable and who are being compensated for it. Some of them have treated me. I have no evidence that any of the treatments they’ve prescribed for me were chosen as a quid pro quo for pharmaceutical company money. I was always offered a choice of treatments and, together, the doctor and I determined which would be the most effective treatment for me.
Full disclosure: I also received money from a Big Pharma company. I’m a Lemtrada (alemtuzumab) patient and, last year, I participated in a Lemtrada advisory board meeting. Sanofi-Genzyme, paid me a small fee for my time and my social media knowledge. My travel and lodging expenses were also covered.
Is this good or bad?
I know that some of you reading this are thinking this is all an example of how pharmaceutical companies are paying out billions to make tens of billions, and that the focus on medications is keeping us from moving more quickly toward approval of stem cell therapy in the U.S. or toward a cure for MS. And, maybe there’s some truth to that.
On the other hand, I truly believe that the medications I’ve taken as an MS patient have eased my symptoms and slowed the progression of my disease. More recently, it appears that my progression may have been stopped and — maybe, maybe — even reversed.
So, is it reasonable for pharmaceutical companies to make payments, large or small, to help doctors with their research or to educate patients or other medical professionals? What do you think?
(This post first appeared as my column in www.multiplesclerosisnewstoday.com).
…and reading this piece has made me wonder at how much money may flow from countries other than the US, like Denmark. Not expecting any answers, just letting a little brain fog fly free.
Hi Gale,
Thanks for your comment. You’ve made me wonder why you’re wondering. Who in a foreign country do you think might be paying U.S. doctors? What’s the benefit?
Ed
I am just wondering what the doctors are being paid for. Is it for prescribing the drug or are they actually doing follow-up studies on the drug for the drug company? Is the money for work or does it go into the doctor’s pocket. Many doctors are involved in clinical trials prior to drugs making it to the market, as well as follow-up studies. These studies cost money, not only for the people doing the work but for the patients also. These tests are needed and regulations are quite strict. When you ask “How much do doctors make when they consult, research, etc.?”, do you actually know what the money is being used for?
The doctors I know receive payments from drug companies, primarily, for speaking to patients who are thinking about using a specific drug and are attending an information session about it. Some of the money is also given to support research. The payments for research are separated out on the website that I profile in my post.
Ed