Notes About The 'Dollars For Docs' Data


Drug companies have long kept the names of their speakers — and how much they pay them — secret. But last year, seven companies began posting doctors’ names and compensation on their web sites, some as the result of legal settlements with the federal government.

ProPublica took these disclosures, totaling $257.8 million to about 17,700 providers, and assembled them into a single, comprehensive database that allows patients to search for their physician.

Use the database widget at the left to search by doctor name or state, or head over to ProPublica's site to use the complete database.

It was not easy. The firms constructed their sites in a way that made it nearly impossible to analyze or, in some cases, even download their data. And each firm disclosed its data differently. Some, for example, simply included speaking. Others also detailed consulting. Sometimes, the value of business travel and meals were listed, too.

ProPublica is committed to updating the database as additional companies release their payment data. The health care law, signed in March, mandates that all drug companies report such data to the federal government beginning in 2013. That information will be posted on a government web site.

Several things to bear in mind about the data:

— Only the seven companies that have disclosed payments on their web sites are included. (They are AstraZeneca, Cephalon, GlaxoSmithKline, Eli Lilly, Johnson & Johnson, Merck and Pfizer.) Their combined prescription drug sales amounted to 36 percent of the U.S. market in 2009. Though that is a substantial share, more than 70 drug companies operate in the U.S. As such, the data may not be wholly representative of the industry.

— The data is from payments made in 2009 and 2010. But not all companies reported payments for every quarter during that period.

— Although most of the money went to physicians, other practitioners, including nurses and pharmacists, are also included.

— Practitioner names and addresses are listed as the companies released them and may vary. For instance, some companies include a middle initial, and others do not. Some may list a physician’s suburban office; others may list a city address.


How Patients Can Use This Data

We created our Dollars for Docs database partly as an educational tool. How can patients use it? We interviewed medical and academic experts to ask for advice. Here are some questions and answers:

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 seven 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.

"If you see somebody who has received a sum of money, particularly a relatively large sum, the first question would be, 'Am I on any products that are manufactured by that company?'" said Dr. Fred Ralston, Jr., president of the American College of Physicians.

Others say the information should carry less weight. Dr. Perry Fine, a Utah pain doctor who is president elect of the American Academy of Pain Medicine, said 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's not on the list. What does that mean?

A. ProPublica included payments only from the seven 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 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.

— Nick Kustnetz, ProPublica

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