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Dollars for Docs Mints a Millionaire
Drug payments » New data show drugmakers’ payments to hundreds of thousands of doctors, and some have made well over $500,000.


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In contrast, GlaxoSmithKline spent $52.8 million on speakers in 2010. That fell to $24.1 million in 2011 and $7.6 million in the first three quarters of last year.

Glaxo spokeswoman Mary Anne Rhyne wrote in an email that the company’s spending tracks with new drugs or new uses for existing products. "That activity has been relatively low in the past year, so spending for speaker programs has been lower, too," she said.

At a glance

Utah doctors paid $25.8 million by drug companies

Drug companies have made $25.8 million in payments to Utah doctors since 2009 for research, consulting, travel and entertainment — a common practice, the scope of which is only now becoming clear and causing uneasiness in medicine.

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The top recent speaking programs for Glaxo involved Advair, a drug for asthma and chronic obstructive pulmonary disease, and Jalyn, which treats problems with urination for men with enlarged prostates, Rhyne said.

Glaxo and other top pharmaceutical companies have laid off thousands of workers in the past couple of years as their top drugs have lost patent protections, the pipeline of new drug approvals has slowed, and cost pressures arose.

Other companies contacted by ProPublica about their spending would not reveal which products they paid speakers to extol or why.

"We don’t disclose how we allocate our speaker program budget," Tony Jewell, a spokesman for AstraZeneca, said in an email. AstraZeneca’s spending on promotional speakers decreased from $31.6 million in 2010 to $17.6 million the following year and $12.2 million in the first three quarters of 2012.

"The decrease in spending is based on a variety of factors, including where our medicines are in their life cycles and brand budgets and strategies," Jewell wrote.

The company’s blockbuster antipsychotic drug Seroquel went off patent last year. Another top drug, Nexium, which treats acid reflux, goes off patent in 2014.

Because each company is in a different stage with its blockbuster drugs, it’s difficult to compare their outlay on speakers and consultants head to head.

It may be too soon to tell whether continued publicity over the spending will cause companies to cut back further, said Chimonas, of the Center on Medicine as a Profession. But transparency might be having some effect.


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At a recent conference, Chimonas said she heard that pharmaceutical companies themselves are using the disclosures about payments to "push back on doctors who are greedy."

"They can say, ‘No. We see you’re taking this amount of money from our competitor. Why should we give you more than that?’" she said.

A Harder Sell For Antipsychotics

Once a reliable profit machine for drug companies, psychiatric drugs are now a challenge. And drugmakers are fighting hard to stanch the losses.

Starting in the 1990s, when the second generation of antipsychotics hit the market, drugmakers enjoyed a period of wild profitability. Doctors embraced these new drugs, such as Risperdal, Seroquel and Zyprexa, as safer and causing fewer of the troubling side effects of older psychiatric drugs. Domestic sales of Seroquel hit $4.7 billion in 2011, the year before it went off patent.

But as the drugs lost their patent protection, their makers have tried to shift the market to newer drugs in their stables. Critics say these new drugs are not appreciably different, but the drug companies claim they are easier to take or have fewer side effects.

Johnson & Johnson, for example, lost its Risperdal patent in 2008 but now markets Risperdal Consta, a long-acting injection, and Invega, another antipsychotic. AstraZeneca lost Seroquel but is now marketing Seroquel XR, which works for an extended period.

The pressure to reclaim sales is great. Overall, the market for antipsychotics dropped from $18.5 billion in 2011 to $13.7 billion last year, according to IMS Health, which closely tracks the industry’s ups and downs.

The newer drugs, like their predecessors, need someone to explain their benefits, several doctors said.

"I actually enjoy the aspect of educating my counterparts about developments in the field," said Dr. Gustavo Alva, a California psychiatrist.

Alva has received $663,751 for speaking and consulting since 2009 for the companies in Dollars for Docs. He separately discloses speaking for other companies as well.

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