Drug Companies Gave Vermont Health Care Providers Gifts Worth $4.9 Million Over Two Years

Specifics Had Been Hidden by “Trade Secret” Designation

WASHINGTON, Nov. 4, 2008 – Pharmaceutical company payments to health care providers in Vermont between July 2002 and June 2004 totaled more than $4.9 million, considerably more than the $2.7 million that had previously been disclosed in detail to the public by Public Citizen in an article in the Journal of the American Medical Association (JAMA) in March 2007.

The details had been hidden by 21 companies that claimed that the data were trade secrets. Public Citizen obtained these data through litigation and released an updated analysis including the newly obtained data in a research letter published today in the JAMA.

In 2005, Public Citizen sued the attorney general of Vermont and these pharmaceutical companies to unseal information about payments designated as trade secrets. These comprised 43 percent of all payments (9,182 of 21,409) and 56 percent of all dollars ($2.72 million of $4.90 million) paid to health care providers in that state.

One of the JAMA letter’s key findings is that Vermont’s doctors received $3.2 million in payments over $100 from drug companies, 86 percent of all such payments to health care providers. These findings strongly suggest frequent violations of professional guidelines put forth by the American Medical Association and Pharmaceutical Research and Manufacturers of America, both of which prohibit many gifts from exceeding $100.

“Patients should be able to find out which drug and medical device companies are paying their doctors and how much,” said Dr. Peter Lurie, deputy director of Public Citizen’s Health Research Group. “If doctors and drug companies don’t feel comfortable about making the relationships public, they ought to reconsider the relationship itself.”

Payments that had been shielded from disclosure by trade secret claims were larger than those originally disclosed in full, more likely to involve payments to speakers and less likely to be for one-on-one interactions between drug company representatives and physicians.

Research shows that these payments influence physicians’ prescribing decisions. If they didn’t, it’s unlikely that pharmaceutical marketing would be the multibillion-dollar industry it is, Lurie added. In 2004, according to a recently published study, the industry spent $57.5 billion on marketing.

The letter is a follow-up to Public Citizen’s 2007 JAMA study as well as testimony that summer before the Senate Committee on Aging. The testimony investigated the limitations of payment disclosure legislation in the five states that have such laws. A bill currently before the U.S. Congress would require disclosure into a national database.

“Our research letter underscores the need to prevent companies from evading disclosure through trade secret claims,” said Dr. Joseph Ross, the first author of the paper and a faculty member at the Mount Sinai School of Medicine. “To evaluate their doctor’s relationship with the drug industry, patients need the full picture.”

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Posted: November 2008


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