ROBERT SIEGEL, HOST:
Now, how much money companies that make drugs and medical devices spend than on M.D.'s and other medical professionals. The Affordable Care Act requires those companies to report payments that they make to doctors, and tomorrow the federal government is expected to release a lot of new data. One group that will be scrutinizing the data is ProPublica, the nonprofit investigative newsroom. ProPublica's Dollar for Docs project has been monitoring drug-industry payments for the past four years and joining us to talk about it is Charles Ornstein of ProPublica. Welcome.
CHARLES ORNSTEIN: Thanks, Robert.
SIEGEL: First, what's your best estimate of how much the pharmaceutical companies pay doctors, not in support of research but for other purposes?
ORNSTEIN: I think that's pretty clear that we're talking about billions of dollars a year that go to things like promotional speakers, consulting, meals and there's a whole list of other things that don't constitute research.
SIEGEL: Does a relatively small share of the medical profession receive most of the drug money or is it spread around a large number of doctors?
ORNSTEIN: What we've found as we've looked at our Dollars for Docs data is that hundreds of thousands of doctors get some form of payments. Most of those are just small meals. They are a relatively small group of doctors who receive a lot of money. And by a lot of money, I'm talking about individually hundreds of thousands of dollars a year.
SIEGEL: And what is tomorrow's federal reporting likely to show or what questions do you hope it will answer?
ORNSTEIN: Well, going back years and years, there's been this sort of opacity surrounding, what drug companies spend on doctors and who receives the money? So I think we will begin to answer that question tomorrow. There's some problems with this federal release. First of all, we're only going to see the data from the last five months of 2013. So you're not going to get a full picture. But we're going to begin to fill in some of the blanks that we haven't seen until now.
SIEGEL: Now, the criticism of doctor's taking money from drug companies is that they will effectively endorse a product, not just because of its efficacy, but because they've been paid to do that. How do doctors typically respond to that criticism?
ORNSTEIN: Well, many doctors view that as an assault on their professionalism saying that they would never compromise the patient in front of them for a meal, or a pen or even money to speak on behalf of the drug. But there's a whole body of research that suggests that payments do have an effect on doctors and the way that they think about the industry and particular drugs. And a number of critics of the practice say the pharmaceutical industry, which is a money-making business, would not spend hundreds of millions or billions of dollars on this if it weren't returning a reward to them.
SIEGEL: You quote a cardiologist from Newark, New Jersey as defending his fair-size income from drug companies, I gather - over $200,000.
ORNSTEIN: He received $270,000 from just six of the companies that we track. So it's possible he made more than that. I think he thinks that he only speaks on behalf of drugs for which there is a robust body of clinical evidence. But when you talk to outside experts, what they say is if you make so much money that perhaps your second home, or your vacations or your child's college tuition is dependent upon your relations with industry, how independent can you truly be? And are you likely to prescribe a drug that perhaps your patients don't need or convince other doctors to do that?
SIEGEL: Your website says that the Dollars for Docs project of ProPublica has been consulted more than 800 million times the last four years. What are patients learning and how are they reacting to the information that you provide them with?
ORNSTEIN: Look, I think some patients go into it and just implicitly trust their doctors. And that's fine. I think patients should be able to have whatever relationships they want with their physicians. But there are a number of patients who have doubts about what their doctors are prescribing for them. And I think for those patients, if they see that their doctor prescribed a drug that they already have questions about and then subsequently see that their doctors getting money from that company, sometimes it causes a patient to find another doctor. But the very act of having the information is very empowering to patients because then they actually are a party to all of the information that goes into the transaction.
SIEGEL: Charles Ornstein, thanks for talking with us.
ORNSTEIN: Thanks very much.
SIEGEL: Charles Ornsetin of ProPublica on the organization's Dollars for Doctors research. Tomorrow the federal government is set to release new data about payments to doctors by drug and medical device companies.
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