How to Evaluate Drug Payment Data
By Nicholas Kusnetz, ProPublica
Monday, June 17, 2013
[Editor's Note: ProPublica is a New York-based, independent, non-profit newsroom with a sole emphasis on investigative journalism in the public interest. ProPublica shares its investigative reports with news media, provided its work is reproduced in full and unedited. The "Dollars for Docs" database can be accessed online at ProPublica.org.]
Drug companies have long kept secret details of the payments they make to doctors for promoting their drugs. But 15 companies have now made some of that information public. ProPublica's "Dollars for Docs" pulls their disclosures into a single database so patients can easily search for their doctor. We created "Dollars for Docs" database partly as an educational tool. How can patients use it? Here are some suggestions.
Q. My doctor is on this list. Should I care?
A. If your doctor is listed, it's because he or she received money from one of the drug companies for promotional activities or consulting. Payments are legal, so it doesn't mean your doctor has done anything wrong. But research has shown that drug company marketing can influence what a doctor prescribes, and some experts say it is cause for concern.
Others say the information should carry less weight. They say the amount of money a doctor receives is less important than personal recommendations and the doctor's training and experience.
One word of caution: Some doctors in our database have the same or similar names, so be sure to confirm with your doctor that he or she is actually the one on the list. Names and addresses on the data are as disclosed by the companies, and they sometimes use variations.
Q. My doctor is not on the list. What does that mean?
A. ProPublica included payments only from the drug companies that have made these relationships public so far. Many doctors do not do promotional work or consulting for drug companies. Others may receive such payments from companies that haven't yet disclosed them. So even if your doctor isn't on the list, experts say it's worth asking about the issue.
Q. What's the best way to bring up the issue with my doctor?
A. Although it can feel awkward, some experts say it's important to ask about potential conflicts of interest. Others say patients should trust their doctors to do what's right for them. If you do raise the issue, tell your doctor you want to feel confident the drugs he is prescribing for you are best for the job.
According to a 2010 national survey by Consumer Reports, conducted for this project, 70 percent of adults say doctors should tell their patients about payments they've taken from a drug company whose drugs they are about to prescribe.
Ask first if your doctor has any financial relationships with drug companies. If so, ask about what companies are involved, the nature of each relationship and the duration. Most often, doctors are paid for promotional activities, such as speaking to other doctors about a drug, or for consulting or research.
It's important to ask whether medications you are taking are made by the companies. If the answer is yes, it's not necessarily a problem but is worth discussing further.
Q. How can I be sure my doctor is offering unbiased advice about a drug?
A. If your doctor has prescribed you medication made by a company he or she receives payments from, you should ask whether there are any cheaper generic alternatives. How does the drug compare to others in its class? What are the side effects? Are there alternatives with fewer side effects? And importantly, are there non-drug alternatives, such as diet, watchful waiting or physical therapy?
It may be that the drug you are on is the best option. But sometimes a drug company will market a new, more expensive version of an established drug even when the older one is cheaper and effective.
Asking these questions will show your doctor you're aware of these issues.
Q. Where can I learn more about drugs my doctor prescribes?
A. Searching the Web will bring up a wealth of links and literature. One site that has comprehensive drug and supplement information is MedlinePlus.