Top Medicare Prescribers Rake In Speaking Fees From Drugmakers
When the blood pressure drug Bystolic hit the market in 2008, it faced a crowded field of cheap generics.
So its maker, Forest Laboratories, launched a promotional assault on the group in the best position to determine Bystolic's success: those in control of prescription pads. It flooded the offices of health professionals with drug reps, and it hired doctors to persuade their peers to choose Bystolic — even though the drug hadn't proved more effective than competitors.
The strategy worked. In the 2012 fiscal year, sales of Bystolic reached $348 million, almost double its total from two years earlier, the company reported.
Now, data obtained and analyzed by ProPublica suggest another factor in Bystolic's rapid success: Many of the drug's top prescribers have financial ties to Forest.
At least 17 of the top 20 Bystolic prescribers in Medicare's prescription drug program in 2010 have been paid by Forest to deliver promotional talks. In 2012, they together received $284,700 for speeches and more than $20,000 in meals.
Nearly all those doctors were again among the highest prescribers in 2011, the most recent year for which Medicare data are available. Forest began disclosing its payments only last year; the company didn't specify which drugs doctors spoke about.
Dr. Bernard Lo, who was chairman of a national panel examining conflicts of interest in medicine, said he doesn't believe the findings are coincidental.
When there's no evidence a drug is better, "You have to question: Why are doctors prescribing this?" said Lo, president of the Greenwall Foundation, a New York City nonprofit that funds bioethics research. "What your evidence suggests is that there is a financial incentive for doctors who receive payments from drug companies" for pitching their products.
Until now, doctors' prescribing habits have been secret from all but pharmaceutical companies, which pay millions of dollars for such information from other firms that collect it.
ProPublica's analysis marks the first time anyone has matched payment data made public by drug companies with physician prescribing records from the Medicare drug program, which covers about 1 out of every 4 prescriptions in the U.S.
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