Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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Pharma Payments to HCPs Topped $8 Billion in 2016. Allergan & Celgene Paid Out the Most!

Pharma Payments to HCPs Topped $8 Billion in 2016. Allergan & Celgene Paid Out the Most! | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Payments from drug and device companies to physicians and teaching hospitals hit more than $8 billion in 2016 according to Open Payments data recently released by CMS.

All told, nearly 631,000 physicians and approximately 1,146 teaching hospitals received $8.18 billion in payments and ownership and investment interests in 2016, according to tallies compiled by the CMS. Last year's total was $7.52 billion.

About half of the overall payments were for research and $2.7 billion were in payments not related to research. A little more than $1 billion stemmed from ownership or investment interests.

Of the largest pharmaceutical companies, Allergan paid out the most in 2016 with $66 million in total payments. Dr. George Patrick Maxwell, a plastic surgeon in Nashville, is listed as the highest payment recipient from Allergan, with $4.6 million.

Celgene was the second-highest spender with a total of $54 million in payments last year. Of its recipients, Boston oncologist Dr. Kenneth C. Anderson a took in the most, with $1.9 million.

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21st Century Cures Bill Would Weaken the Sunshine Act Provision in the Affordable Care Act

21st Century Cures Bill Would Weaken the Sunshine Act Provision in the Affordable Care Act | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Tucked into the 21st Century Cures legislation that was negotiated by the House and Senate late last week is a controversial provision to exempt companies from reporting payments made to doctors for receiving continuing medical education sessions, medical journals, or textbooks.

 

The move — which has sparked objections from Senator Chuck Grassley (R-Iowa) — is the latest in a long-running attempt to roll back requirements for reporting such payments to a federal database that tracks financial relationships between companies and physicians.

 

Known as OpenPayments, the database was launched in 2014 in response to concerns that financial ties between drug and device makers and doctors may unduly influence medical practice and research. It was included in the Sunshine Act provision in the Affordable Care Act. As we noted previously, an analysis earlier this year found that payments can affect prescription rates.

 

Grassley, who was instrumental in pushing legislation that led to the database, may try to place a hold on the bill “unless this provision is removed,” he said in a statement. “The Sunshine Act brings transparency to a big part of the health care system for public benefit. Transparency brings accountability wherever it’s applied. With taxpayers and patients paying billions of dollars for prescription drugs and medical devices, and prices exploding, disclosure of company payments to doctors makes more sense than ever.”

 

Drug company payments have effect on prescription rates, analysis finds

Consumer groups are echoing this sentiment. “In a time of increasing concern about drug prices and spending, it would be unwise to reduce transparency about the financial relationships associated with drug promotion,” said Allan Coukell, senior director for health programs at the Pew Charitable Trusts (the language can be found in section 4009).

Pharma Guy's insight:

Massachusetts Senator Elizabeth Warren also objected to a provision that would allow drug companies to avoid disclosing fees paid to doctors for continuing medical education, medical journals, or textbooks. Warren tore into the package late yesterday on the Senate floor, saying “I will fight it because I know the difference between compromise and extortion.”

 

Related article: “21st Century Cures Bill Hides CME Payments & Allows Off-Label Promotion”; http://sco.lt/62vgQr

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AMA & Many Other Physician Groups Lobby to Keep CME Payments Out of the Sunshine

AMA & Many Other Physician Groups Lobby to Keep CME Payments Out of the Sunshine | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Nearly 100 national and state medical societies from around the United States are backing a Senate bill (see “21st Century Cures: Hide CME Payments & Allow Off-Label Promotion”; http://sco.lt/62vgQr) that would exempt drug and device makers from reporting payments made to doctors for receiving continuing medical education, or CME, sessions, medical journals, or textbooks. Among them are the American Medical Association and the American College of Cardiology.

 

The move is the latest push in a long-running effort to roll back requirements for reporting such payments to a federal database, which tracks financial relationships between companies and physicians. Known as OpenPayments, the database was launched in 2014 in response to concerns that financial ties between drug firms and device makers and doctors may unduly influence medical practice and research. It was included in the Sunshine Act provision in the Affordable Care Act. A recent analysis found that payments can affect prescription rates.

 

But more than once over the past few years, the Centers for Medicare and Medicaid Services, which maintains the database, appeared to change its mind on reporting requirements for CME payments, in particular. These payments are made by manufacturers or group purchasing organizations to CME providers, which are either commercial firms or nonprofits that organize courses for physicians.

 

CME has been a particularly controversial issue, with accusations that drug and device companies not only fund the courses but they also tightly control the educational curriculum. Last year, industry support for CME totaled $693 million, a 2 percent rise, from the previous year, according to the latest report from the Accreditation Council for Continuing Medical Education, which regulates CME activities.

 

In late 2014, CMS ultimately decided that reporting CME payments would be required. As far as the agency is concerned, medical information — whether in the form of courses, journals, or textbooks — has value that physicians would otherwise have to pay for themselves. However, the CMS decision prompted a lobbying push by industry and medical societies to eliminate the reporting requirement.

 

The support from the medical societies for the bill, which is called the Protect Continuing Physician Education and Patient Care Act, is hardly surprising. In a letter to US Senator John Barrasso, a Wyoming Republican and a physician who introduced the bill, the medical groups argue, however, that Congress initially intended to create such exemptions and CMS may hurt medical practice.

 

“Passage of this bill is urgently needed to remedy onerous and burdensome reporting obligations imposed by CMS that have already chilled the dissemination of medical textbooks and peer-reviewed medical reprints and journals, and to avert a similar negative impact on access to independent” CME, they wrote to Barrasso in a June 30 letter.

 

“When a company gives a grant to an accredited CME provider, it’s pretty hands off. They’re not supposed to suggest speakers or influence the curriculum, for instance,” said Thomas Sullivan, president of Rockpointe. “So if a company that supports commercial CE has no control (over the use of its grant dollars), I don’t see why that should be reported. Doctors don’t have the direct relationship with the company.”

 

“It’s a stretch to view free textbook and free medical education as being anything other than a benefit to physicians,” said Daniel Carlat, who runs a company that publishes CME newsletters for mental health practitioners. “These are not direct benefits to patients. The only way these would benefit patients is if a drug company gave free books or courses to patients themselves.”

Pharma Guy's insight:

For a closer look at CME funding data, read "For First Time in Seven Years, Pharma Support of CME Increases"; http://bit.ly/1Ctqf8D 

 

As you can see from the charts, most of the increase in CME funding comes from for-profit CME providers - those so-called "hands-off" 3rd parties. With regards to pharma grants to such groups, it's widely understood that pharma's hands remain "off" perhaps the first time, but if the pharma sponsor is not satisfied with the MECC's CME program, then there may not be a second round of funding via that "independent" CME provider.

 

A Pharma Marketing News survey asked respondents if CME activities that accept commercial support from pharmaceutical companies have more bias that activities that don't and what should be done to limit any potential bias. About one third of respondents said that pharma/device companies should cease funding CME courses provided directly by for-profit, third-party companies (eg, medical education and communication companies), but continue paying for courses offered by medical schools, teaching hospitals and medical societies. Another third disagreed and the rest weren't sure. For more, see http://www.surveys.pharma-mkting.com/PharmaCME.htm

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Sun Rises on UK Pharma Payments to HCPs

Sun Rises on UK Pharma Payments to HCPs | Pharmaguy's Insights Into Drug Industry News | Scoop.it

[Curated by @pharmaguy; image copyright 2016, Pharma Marketing Network.]

 

UK pharma has published details of the payments and benefits in kind it provides to doctors, nurses and pharmacists as long-awaited industry transparency rules come into force.


The ABPI's publically-available database, Disclosure UK, reveals the industry paid healthcare professionals (HCPs) £340.3m in 2015, two-thirds of which (£229.3m) was for R&D work.


The remaining £111m was for a range of commercial rather than R&D activities, with nearly half of that money (£49.3m) going on a range of service and consultancy fees.


The next largest chunk of money was for event-related payments, which accounted for £31.4m in 2015, with £10.8m of that going on travel and accommodation.


Closely behind that were donations and grants to healthcare organisations, on which UK pharma companies spent £30.3m in 2015.

Pharma Guy's insight:

Compare this to how Pfizer dishes out dollars to docs in the U.S.: “Pfizer Reveals (Almost) All Payments to Physicians”; http://bit.ly/d5u15G

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High Prescribing Docs Get More Sunshine ($) from #Pharma

High Prescribing Docs Get More Sunshine ($) from #Pharma | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Using data from the Medicare Prescription Drug Program (Part D) and the Open Paymentsprogram, HealthGrove examined doctor prescribing rates for all of 2013 and pharmaceutical payments data from August to December of 2013. Within this data, a pattern emerges: doctors who prescribe a lot of drugs tend to get more money from pharmaceutical companies. Adjusting by physician specialty, the higher the doctor prescribing rate, the stronger the chance she receives pharmaceutical industry payments.


To categorize “high-prescribing” doctors, we looked at prescribing rates within the various specialities and grouped physicians into percentiles. The highest prescribers fell above the 80th percentile in either claim counts or claim costs per patient. Whether a doctor is writing more prescriptions per patient (claim count) or writing more expensive prescriptions per patient (claim cost), the trend remains the same.


The first tab, ranking prescription counts per patient, shows that 45.3 percent of the highest prescribing doctors (above the 80th percentile) received payments from the pharmaceutical industry, with the average payment totaling $146 per physician. On the other hand, only 21.4 percent of the lowest-prescribing doctors (those below the 20th percentile) received industry payments. And, if they did, the average payment was only $89. High prescribing doctors were not only more likely to receive payments from pharmaceutical companies, but these payments were also larger, on average.

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Where's the Sunshine Law for Journalists?, Asks @Sander_Flaum

Where's the Sunshine Law for Journalists?, Asks @Sander_Flaum | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Nearly every week in the Wall Street Journal or the New York Times, you'll find articles about the “murky” dealings of doctors and pharmaceutical companies. Here's a sample headline: “Many of the Biggest Sums Paid to Physicians Didn't Involve Patient Care.” No kidding! Do they expect doctors to teach or consult for free? 


Why can't they be happy with the “generous” allowances from insurance companies and Medicare? Who cares that every year they see more patients for less money?


Here's an idea for another Sunshine Act—require journalists who write about pharma to disclose every source they use and list every person or institution at whose table they've dined. Do I hear protests that this would have a chilling effect on journalism? Well, what about the chilling effect these jokers are having on medicine? The journals call it Sunshine. I call it shameful.

Pharma Guy's insight:


There's one BIG difference between physicians taking money from pharma and journalists taking money from pharma - we don't trust journalists with our health and to help us make life and death decisions. 


Nevertheless, Flaum has a point about journalists feeding at pharma's trough - a topic I've written about before. For example, with regard to journalists, "our core strategy," said Pfizer's former global PR chief, Ray Kerins, is "engage and educate," which, IMHO, can be loosely translated to "free lunch and schmooze," the same strategy that has worked so well in marketing to physicians. Unable to send physicians on all-expenses paid junkets due to self-imposed industry restrictions on gifts to physicians, Pfizer apparently has shifted its junket budget to journalists who seem eager to accept the offer. Read more about that here: A New Era of Pharma Marketing: Direct to Journalist


Flaum should also have mentioned bloggers, many of whom also dine at pharma's table and are adamant that they too are unbiased when it comes to reporting about the industry. For more on that read: Should Bloggers Dine at Pharma's Table?

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95% of N.J. docs who receive $ from Big Pharma are NOT identified!

95% of N.J. docs who receive $ from Big Pharma are NOT identified! | Pharmaguy's Insights Into Drug Industry News | Scoop.it

New Jersey physicians and teaching hospitals received at least $20 million dollars from pharmaceutical companies, according to Open Payment, the federal government's new website.


The largest payment was the $2,694,286 given by Princeton-based Otsuka America Pharmaceutical Inc to 24 unidentified physicians. Bristol-Myers Squibb Co. gave 35 unidentified recipients $2,007,857.


The new federal website is designed to give patients insight into the financial ties their physicians may have with pharmaceutical companies.


Yet, in New Jersey, roughly 95 percent of the total money donated went to recipients who were not identified in the report, a provision allowed by regulations whenever the accuracy of a payment is in dispute.

Pharma Guy's insight:


What's up with this? Is NJ a special case, or is this the situation in all states? What a farce!!!! You should read: What to be Wary of in the Govt’s New Site Detailing Industry Money to Docs



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Get Ready to Learn About the Money Doctors Take From Drugmakers

Get Ready to Learn About the Money Doctors Take From Drugmakers | Pharmaguy's Insights Into Drug Industry News | Scoop.it
A piece of the Affordable Care Act requires medical companies to disclose their payments to physicians. The first reports are due out this week


The financial relationships between doctors and the makers of drugs and medical devices have long been hidden. That’s poised to change on Tuesday with the expected release of the first government data about how much medical companies have paid doctors.


Both doctors’ groups and manufacturers spent heavily to keep the details of these transactions from public view. The Physician Payments Sunshine Act, which eventually passed into law as part of Obamacare, is mentioned in almost 2,000 lobbying reports since Republican Senator Chuck Grassley of Iowa introduced the legislation in 2007. It’s impossible to know how much companies and medical societies have spent on the issue, because lobbying disclosures lump together their spending on many issues.


Pharma and trade groups for biotech and medical device makers urged Marilyn Tavenner, head of the Centers for Medicare and Medicaid Services, to let them review the data before they are published. “We express our longstanding support for the goals of the Physician Payments Sunshine Act,” the heads of three industry groups wrote in a Sept. 18 letter. The groups insisted that the website disclosing the data “must provide clear background information and context regarding such industry relationships.” Without that, patients might “form mistaken impressions that all payments to physicians are suspect.”

Pharma Guy's insight:


It remains to be seen how useful this database will be, especially compared with the ProPubica database, which includes reports from just 15 or so pharma companies. As I warned more than a year ago ("Big Sunshine Law Data")pharma companies should have been more pro-active and worked directly with their physicians prior to submitting the data to CMS. To do that effectively requires BIG DATA expertise, which maybe the companies, physicians (and CMS) lacks. 

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AMA Says Docs Need More Time to Review Sunshine Data

AMA Says Docs Need More Time to Review Sunshine Data | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The American Medical Association (AMA) is calling on the Centers for Medicare and Medicaid Services (CMS) to expand the timeframe for registering and using the Open Payments system to allow physicians adequate time to review and seek correction of inaccurate claims made by pharmaceutical companies, device manufacturers, and group purchasing organizations under the Sunshine Act. The call comes amidst continued poor functionality of the government website and poor communication to physicians and the public, which has led to widespread confusion among physicians and hindered education efforts about the program.


CMS reports that it has reopened the Open Payments database as of today, but indicates it will only allow physicians until September 8th to complete registration and seek correction of data.  Yet, the agency has not fixed the major problems that continue to mark the roll-out of this database including confusing and inaccurate information, lack of reliable functionality, and excessive time required to register and review reports.  This inadequate response will lead to inaccurate publication of data.  


While the AMA believes that transparency can strengthen our health care system and benefits both physicians and patients, if the government releases incorrect information to the public it can create misinterpretation and misrepresentation and inhibit the delivery of quality care to patients.


“In order for the Sunshine Act to be effective, physicians need enough time to review and correct any inaccurate data that may be reported,” said AMA President Robert M. Wah, MD. “The issues that resulted in the system being taken offline further underscore the need for more time than CMS proposes to ensure the system is actually ready and that physicians have adequate time to register, review, and seek correction of inaccurate data. The lack of faith physicians have in the system at this point in time, is making them wonder if taking time away from patients to go through the process is even worthwhile.”


CMS created widespread confusion by taking the Open Payments database offline without notice to physicians or physician organizations and without any indication of when the database would be available again. According to media reports, the Open Payments system was taken offline the evening of August 3rd due to significant technological problems. CMS inadequately communicated about website failures, not releasing a public statement about the system being offline until August 7th and not providing any indication of when the database would be available again, causing confusion among physicians.


Physicians were already given a short window to go through the cumbersome process of registering for the Open Payment System (which required a more than 360 page guidebook), reviewing information reported about them, and disputing any inaccurate data before publication in September. In order to get proper participation in the program to ensure all data reported is fair and accurate, AMA is asking CMS to significantly expand the timeframe for registration and data correction until March 31, 2015.


While the AMA supports the Sunshine Act, it cannot support the publication of inaccurate data. Wrong information, reduces patient trust which unnecessarily damages patient-physician relationships. Physicians deserve adequate amount of time to ensure the information being reported is accurate.

Pharma Guy's insight:


Meanwhile, Pharmalot reports:


Despite a disruptive tech glitch this past week, the U.S. Centers for Medicare and Medicaid Services is sticking with its Sept. 30 date for publishing detailed information about how much money drug and device makers pay physicians and teaching hospitals.

CMS announced today it would extend to Sept. 8 from Aug. 27 a review period for doctors and teaching hospitals to get an online preview the payment data before it goes public, in order to compensate for the 11 days the system was offline while CMS investigated a data mix-up.


But notably, CMS did not change the Sept. 30 date for the launch of a widely anticipated online searchable database, despite a recent request by some medical groups to delay the publication by six months so that doctors have more time to review and correct any inaccurate payment data.


[UPDATE: Meanwhile, more problems emerged. CMS is withholding about one-third of the data from the site. Why? The agency is "returning records to the manufacturers and group purchasing organizations because of intermingled data, and will include these records in the next reporting cycle," a spokesman tells us. This latest snag was reported byProPublica. CMS is due to report the next batch of payment data in June 2015]

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Docs Complain to CMS About ‘Sunshine’ Data Disclosures

Docs Complain to CMS About ‘Sunshine’ Data Disclosures | Pharmaguy's Insights Into Drug Industry News | Scoop.it
A group of medical societies and pharmaceutical industry trade groups is pushing the government to flesh out data that will be published next month showing how much drug makers pay doctors.


They sent a letter today to the Centers for Medicare and Medicaid Services to ask the agency to explain what context will be provided to help the public understand the justification for payments, such as speaking fees and grants used to bankroll clinical research.


The letter is signed by more than 20 medical societies and organizations including the American Urological Association, as well as heavyweight industry trade groups Biotechnology Industry Organization and the Pharmaceutical Research & Manufacturers of America.


The missive was sent as CMS plans to post the payment data in an online, searchable database as required in the Sunshine Act provision of the Affordable Care Act. The provision was passed in response to concerns that medical practice may be unduly influenced by industry.


The law requires most drug and device makers to report to CMS detailed information about payments and gifts provided to U.S. doctors and teaching hospitals. The disclosures are being made in stages, but September marks the debut when payments will appear publicly.

Supporters of the Sunshine Act say the transparency will provide useful information to patients about the relationships their doctors may have with drug or device makers, and serve as a deterrent to the more extreme examples of industry money unduly influencing medical care.


But some doctors and companies fear payment data will be misinterpreted by the public, or painted with a broad brush. They say there are legitimate interactions that serve to advance medicine, and that doctors should be compensated for services such as consulting for a company about the development of a new product.


Some medical societies teamed up with industry groups to form Partners for Healthy Dialogues, to defend such interactions between industry and doctors, and some of its members signed the letter sent to CMS.


The medical societies and industry trade group lament what they write in the letter is a dearth of context that accompanied CMS’s milestone release of Medicare Part B payments to physicians earlier this year.


Some medical groups say the data did not include context to show which doctors may be abusing the system and which were receiving big payments because of high overhead costs.

Pharma Guy's insight:


A survey revealed that of the more than 1,000 physicians questioned, over half admitted they didn't know that the law requires pharmaceutical and medical device companies to report on expenditures annually, without physician review of the data to correct any inconsistencies or errors, prior to submission to the government. 63% were deeply concerned that a record of these payments will be available in a publicly searchable database.


Listen to this podcast: Physicians Unprepared for Sunshine Law


Questions/Topics Discussed


  • Background regarding the sunshine law, including important dates for implementation.
  • Survey methodology
  • A summary of survey results and what they tell us -- pharma companies might be surprised!
  • How can physicians review the data before it goes public to correct inaccuracies.
  • What is at stake for pharma companies if they do not work more closely with physicians regarding access to the data?
  • What the industry must do to educate their physician clients about the Sunshine Law
  • Will this new form of "Big Data" eventually lead to a significant decrease in payments of all kinds to physicians by the drug industry?


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Congress Will Scrap Reporting Exemption for #Pharma Payments for CME/Textbooks from 21st Century Cures Act

Congress Will Scrap Reporting Exemption for #Pharma Payments for CME/Textbooks from 21st Century Cures Act | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Amid intense criticism, lawmakers have removed a controversial provision in the 21st Century Cures Act that would have exempted companies from reporting payments made to doctors for receiving continuing medical education sessions, medical journals, or textbooks (read “21st Century Cures Bill Would Weaken the Sunshine Act Provision in the Affordable Care Act”; http://sco.lt/6655If).

The provision “is not going to be in the bill when it gets to the House floor” on Wednesday for a vote, a spokeswoman for Rep. Diana DeGette, a Democrat from Colorado, wrote us. The change came one day after Sen. Chuck Grassley (R-Iowa) threatened to put a hold on the entire bill unless the language was removed. We asked the House Energy and Commerce Committee for comment and will pass along any reply.

The exemption — which was widely supported by drug and device makers, as well as physicians — was an attempt to roll back requirements for reporting such payments to a federal database that tracks financial relationships between companies and physicians.

Pharma Guy's insight:

Statement of Dr. Michael Carome, Director, Public Citizen’s Health Research Group

 

Nov. 30, 2016

 

Note: Today, the U.S. House of Representatives passed the 21st Century Cures Act. View Public Citizen’s updated summary (PDF) of the dangerous provisions in the legislation.

 

The U.S. House of Representatives, after weeks of secret deliberations, today passed the dangerous 21st Century Cures Act. The bill has been sold erroneously as a commonsense, bipartisan compromise that enables scientific innovation and medical breakthroughs for America. But in reality, the legislation includes a grab bag of goodies for Big Pharma and medical device companies that would undermine requirements for ensuring safe and effective drugs and medical devices.

 

Moreover, many House members were persuaded to support the bill, despite the many harmful provisions, in exchange for promises of increased funding for the National Institutes of Health (NIH). But there is no guarantee that this funding will be appropriated by Congress in future years. Permanently weakening the U.S. Food and Drug Administration in exchange for tenuous promises of increased NIH funding is a bad deal for patients.

 

We urge the Senate to reject this legislation.

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The Provider Gift Ban: What Happened to All Those #Pharma "Tchotchkes?"

The Provider Gift Ban: What Happened to All Those #Pharma "Tchotchkes?" | Pharmaguy's Insights Into Drug Industry News | Scoop.it

For years, pharma helped keep the manufacturers of Lipitor pens, Prevacid golf club head covers, and other promotional items in business. But when the Pharmaceutical Research and Manufacturers of America (PhRMA) imposed a voluntary ban in 2009 that relegated these and similar tchotchkes to the promotional netherworld of eBay auctions and displays in physicians' offices, nobody expected them to have much of a collectible afterlife.

 

The decision to enact the ban was a no-brainer. PhRMA was not alone in sensing a need to clean up the industry's image by addressing the ethics of providing an array of branded gifts to physicians. Gimmicky marketing mementos like Post-it notes and pens may have seemed harmless enough, but the prescribing influence they carried came into question.

 

“These items were constantly in view and intended to keep specific drug names uppermost in physicians' subconscious. And it worked,” says Dr. Adriane Fugh-Berman, an associate professor in the departments of pharmacology and physiology and family medicine at the Georgetown University Medical Center. Fugh-Berman is also director of PharmedOut, a Georgetown research and education project that, per its website, “promotes rational prescribing and exposes the effect of pharmaceutical marketing on prescribing practices.”

 

These relics of the past have a certain value for those on the hunt. One eBay seller hopes to fetch $20 for a blue pill-shaped Viagra promotional clock that doubles as a business card holder, an item that was once a big weapon in the Pfizer sales rep's arsenal of freebies. And those golf club head covers — in the shape of a stomach, designed to somewhat subtly remind docs of Prevacid's utility in treating heartburn — still make occasional appearances on golf courses across the U.S. In fact, AbelsonTaylor president and CEO Dale Taylor recently spotted a set on a Chicago fairway — in mint condition, no less.

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BMJ Charts Which UK Docs Receive Non-Research Pharma Payments

BMJ Charts Which UK Docs Receive Non-Research Pharma Payments | Pharmaguy's Insights Into Drug Industry News | Scoop.it

This week the Association of the British Pharmaceutical Industry (ABPI) launched its long awaited database of payments to doctors. This is a useful step towards greater transparency and public accountability, but it serves mainly to show just how far we have yet to go.

Pharma Guy's insight:

For more numbers, read: "Sun Rises on UK Pharma Payments to HCPs"; http://sco.lt/5MQJqD 

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Do Payments to HCPs by #Pharma Threaten to Undermine Patient Trust?

Do Payments to HCPs by #Pharma Threaten to Undermine Patient Trust? | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The following discussion was commissioned and controlled [LOL!] by the Guardian, funded by ABPI.

 

Virginia Acha, executive director, research, medical and innovation, ABPI: I trust my GP to be able to hear all of the comments and all of the information, and make a decision in my best interests. The main thing is to support that exploration of all of the facts and in a transparent way.

 

Dr Peter Gordon, campaigner for transparency in medicine: Science strives to be objective. Partnership with commercial interests risks putting the shareholders first.

 

Jeremy Taylor, chief executive, National Voices: The question is at what point health professionals would become embarrassed into disclosure. Suppose patients started using presence on the register as a criterion for choosing some professionals over others? [For more on that, read "“Patients May Leave Docs Who Prescribe Expensive Drugs & Take $ from #Pharma”; http://sco.lt/5RtFk9]

 

Gordon: The significant majority of healthcare workers, scientists and academics have never received payments from outside commercial interests. My worry is those that do – the key opinion leaders ... need not declare.

 

Dr Waheed Jamal, vice president – medical, Europe, GlaxoSmithKline: We have what we call a “no consent-no contract” policy to help make sure there is close to 100% individual-named disclosure in line with the EFPIA [European Federation of Pharmaceutical Industries and Associations]/ABPI code. This means we will no longer work with healthcare professionals in future should they not give consent to disclose the payments that have been made.

 

David Eves, head of compliance, Chugai Pharma Marketing Ltd: The pros are that the development of any therapy will be more meaningful and add value to patient care in the UK. Without that interaction the decisions made regarding where a product may fit will hold less value.

 

Acha: I think the focus so far is on payments to healthcare professionals for their advice and work on specific projects (eg pre- and post-licensing advisory boards). Actually, a good share ... is related to supporting healthcare professionals to attend international congresses and other continuing medical education. This is vital to ensure that our healthcare professionals remain at the forefront of scientific debate. This helps everyone.

 

 

Pharma Guy's insight:

Related: “Most UK HCPs OK with Revealing #Pharma Payments to Docs, But...”; http://sco.lt/7dZ0gz

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Doctors Got $6.5 Billion From Drug, Device Makers in 2014

Doctors Got $6.5 Billion From Drug, Device Makers in 2014 | Pharmaguy's Insights Into Drug Industry News | Scoop.it

U.S. doctors and teaching hospitals got $6.49 billion from drug and medical-device makers in 2014, according to new government data on the financial links between the companies and the people who prescribe their products.


The data released Tuesday range from the royalties paid to hospitals to help develop products to fees provided to medical experts to speak at a dinner with colleagues. The payments are listed in two broad categories: money to fund research and payments to entertain doctors or compensate them for consulting or other non-research purposes.


By disclosing information on the payments, the U.S. is seeking to bring transparency to the financial relationships between drugmakers and health care providers. Those ties can influence how physicians practice, even if they aren’t aware of it, said Jason Dana, a professor at Yale School of Management who studies decision-making.

“If we have a financial incentive to believe something or conclude something, we kind of trick ourselves into thinking it’s true,” he said. “And we’re not always aware we’re doing it.”


The Centers for Medicare & Medicaid Services created a website, called Open Payments, to let people search for data on their medical providers.


The disclosures cover payments to about 607,000 doctors and 1,121 teaching hospitals. Overall, companies made $3.23 billion in payments for research and $2.56 billion for other purposes, according to a summary posted on the website. The data also include ownership interests of $703 million.

Pfizer, Merck

Pfizer Inc., the biggest U.S. drugmaker, reported at least $234 million in research payments and $53.3 million in general outlays. Merck & Co. said it paid at least $97.7 million for research and made at least $27.5 million in general payments. AstraZeneca Plc spent at least $85.7 million on research and $72.5 million on general payments.

Pharma Guy's insight:


I recently used CMS online tool to find out more about the types of payments big pharma companies make to physicians. I only looked at payments for items/services unrelated to research and ownership of stock; i.e., marketing-related items/services. See my analysis here: http://bit.ly/1Ee3uzv 

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Payments to Docs - Where's the Beef! Some Interesting HUH?! Moments; e.g., 40% of Names Missing!

Payments to Docs - Where's the Beef! Some Interesting HUH?! Moments; e.g., 40% of Names Missing! | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The federal government unveiled data Tuesday detailing 4.4 million payments made to doctors and teaching hospitals by pharmaceutical and medical device companies.


This new trove of data covers the period of August to December 2013 and includes general and research payments, as well as payments to companies' physician investors. All told, according to officials from the Centers for Medicare and Medicaid Services, companies spent a total of $3.5 billionduring that period on 546,000 individual physicians and almost 1,360 teaching hospitals.


Pharma Guy's insight:


Some interesting Huh's!:


Many drug and device companies attributed payments to multiple subsidiaries, rather than reporting them under the name of a single parent company. Johnson & Johnson, for instance, submitted payments under at least 15 subsidiaries. Huh?!


The diabetes drug Januvia is reported as both "Januvia" and "Januvia Diabetes." There is one drug simply listed as "KNEES" and another as "Foot and Ankle." Huh?!


CMS had said it would not release about one-third of the payment data for the last five months of 2013 because of inconsistencies and other problems. Huh?!


Forty percent of payments (more than 1.7 million records) did not include the names of the doctors or hospitals that received the payments. Huh?!

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What We’re Learning About Drug Company Payments to Doctors

What We’re Learning About Drug Company Payments to Doctors | Pharmaguy's Insights Into Drug Industry News | Scoop.it
New information on payments by pharmaceutical and medical device manufacturers is being made public this week as part of the Affordable Care Act.


Many, many health professionals have relationships with industry.


Dollars for Docs now includes 3.4 million payments since 2009, totaling more than $4 billion, of which $2.5 billion was for research. For 2013 alone, there were 1.2 million payments valued at nearly $1.4 billion.


It’s not possible to calculate the exact number of physicians represented, because drug companies haven’t used unique identification numbers that cross company lines. But it’s clear that the figure is in the hundreds of thousands.


Excluding research payments, the drugmaker Pfizer appeared to have interactions with the most health care professionals last year — about 142,600. AstraZeneca came in second with about 111,200. Johnson & Johnson and Forest Labs each had nearly 100,000. There are an estimated 800,000 to 900,000 active doctors in the United States.


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Cloudy Forecast on Sunshine Act Data Release?

Cloudy Forecast on Sunshine Act Data Release? | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The past release of Medicare payments to physicians resulted in headlines that focused on money paid to specific physicians as well to specific categories of medical practice with stories taking a national and regional focus.  One could expect much of the same from coverage of the Sunshine Act data, set to be published at the end of September.


However, on August 15 ProPublica reported that the government may actually be withholding one-third of the records from the data base that was to be published, though a press release by CMS on the data base makes no such mention of a delay.  A delay would have many likely side-effects, one of which is to impact the nature of the media coverage of the Sunshine Act data.  That could occur in at least two major ways.


First, it becomes somewhat challenging to report on the data if the data is incomplete – particularly to the tune of one-third of the data being withheld.  What is not known by such a disclosure is just as important as what is known.  The stories that would have been written had there been a complete set of data about which physicians – and which types of physicians – have received the most – and which therapeutic areas have had the greatest investment by companies – and which companies have paid the most – all will have to be qualified if data is withheld.  In other words, every story would include the caveat – “based on what we know now…” Certainly a release of partial data if that happens would have a diluting effect on the nature of the coverage.

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Glitch Prompts Temporary Shutdown of Pharma Payment Verification System

Glitch Prompts Temporary Shutdown of Pharma Payment Verification System | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The government had to take offline its system for doctors to verify payments from drug companies after at least one doctor had payments attributed to him that actually went to someone else.


"After an assessment of the data resulting from a complaint, we discovered that a limited number of physician payment records submitted by at least one manufacturer incorrectly contained information about other physicians," CMS spokesman Aaron Albright said in an email late Sunday. "To protect physician privacy and correct the issue, we have taken the system offline temporarily and will work with the industry to eliminate incorrect payment records."

Pharma Guy's insight:


Oh My! Not another Canadian software problem, I hope!

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US Sunshine Act - Coverage Confusion

US Sunshine Act - Coverage Confusion | Pharmaguy's Insights Into Drug Industry News | Scoop.it

New rules introduced in the US to make the financial relationships between pharma companies and physicians more transparent are themselves lacking in clarity, it would appear.


In February 2013, the Centers for Medicare and Medicaid Services (CMS) published its final rule requiring manufacturers of medicines and medical devices to report payments exceeding $10 or other 'transfers of value' (TOV) made to physicians and teaching hospitals, as well as physician ownership and investment interests.


Under the Act, all applicable manufacturers were required to start collecting data from August 1, 2013, and submit it to the CMS by March 31, 2014. Physicians and hospitals started the registration process on June 1, with a review process kicking off in July.


At the moment that information is still under wraps, but will become open for scrutiny by the public in September, and it is widely anticipated that journalists and other interested parties will be sifting through the data to highlight the biggest spenders and recipients.


Coverage confusion
One the face of it the situation is fairly straightforward: the CMS has set out pretty clear guidance when it comes to financial payments and an informal straw poll of pharma companies suggests they are comfortable with what is covered. However, that is not the case with transactions that come under the TOV category.


One area of confusion is support for medical writing and editorial services, such as may be provided by pharma companies to authors of clinical studies. As reported by PME recently, some pharma companies, such as Pfizer and AstraZeneca, consider this is in scope, while others, such as Shire, believe it is not reportable. 

Pharma Guy's insight:


Proposed Rules for Physician Payment Sunshine Act
Looming Challenges Cloud Implementation

Life science companies are struggling to under-stand the complex reporting requirements and compliance issues presented by existing and new regulations such as the Physician Payments Sunshine Act (PPSA), provisions of which were included in the Patient Protection and Affordable Care Act. While the looming challenge of complying with the Sunshine Act has consumed the attention of the drug and medical device industry, it has tended to obscure other issues of long-term strategic importance, such as the effect of transparency on public perception, and the need for industry to re-structure its spending practices with transparency in mind. 
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