December 18, 2013

Fewer deals for doctors to market drugs, but more trust

People in Maine’s medical industry are pleased that a major pharmaceutical company will stop paying physicians to push its brands.

By Kevin Miller
Staff Writer

WASHINGTON — Representatives of Maine’s medical industry welcomed news this week that one of the largest pharmaceutical companies will stop paying doctors to promote its brand drugs to other physicians.

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Gordon Smith, executive director of the Maine Medical Association

“I think it is another indication that times are changing and that these relationships will be kept at arm’s length, as they should be,” said Gordon Smith, executive director of the Maine Medical Association.

On Monday, the pharmaceutical giant GlaxoSmithKline announced plans to stop paying doctors to deliver speeches to other physicians on behalf of the company’s prescription drugs. The company, which makes such big-name drugs as Advair, Flonase and Zantac, plans to halt the practice by 2016.

“We recognize that we have an important role to play in providing doctors with information about our medicines, but this must be done clearly, transparently and without any perception of conflict of interest,” Sir Andrew Witty, CEO of GlaxoSmithKline, said in a prepared statement.

The company is the first major drug manufacturer to take such a step, although the industry as a whole has scaled back its use of doctors to promote specific drugs as scrutiny of drug industry-doctor relationships has increased. Broad, mandatory disclosure rules are set to take effect next year as part of the Affordable Care Act.

“I think the announcement is part of a longer-term change in drug industry marketing,” said Dr. Daniel Carlat, director of The Pew Charitable Trusts’ prescription project, which examines transparency and conflict-of-interest issues in the industry.

“What we have been seeing is, companies are re-evaluating how they are spending their marketing dollars and they have become very sensitive to (concerns) about paying doctors to give lectures to other doctors,” Carlat said. “So the drug companies have been getting a lot of push-back.”


Paying doctors to talk about particular drugs is a tradition in the medical field. Critics say the paid lectures raise conflict-of-interest concerns. Defenders say the lectures help busy physicians learn about the latest treatment options from their peers.

In 2012, 26 Maine doctors received a total of $181,960 from pharmaceutical companies to deliver speeches, according to the “Dollars for Docs” database compiled by ProPublica, a public interest journalism organization. That total was down from $362,174 in 2011 and from $472,110 in 2010.

Nationwide, spending on “promotional speaking” decreased from $13.2 million per fiscal quarter in 2010 to $2.5 million per quarter in 2012, according to ProPublica’s analysis of disclosures filed by 15 drug companies.

Several Maine physicians totaled more than $100,000 in speaker’s fees in the years from 2009 to 2012. And pharmaceutical companies’ payments to Maine doctors for research or consulting rose considerably during that time, according to the database.

Many academic institutions, medical associations and hospitals require disclosure or have enacted stricter rules governing interaction between doctors and pharmaceutical companies. Carlat, with The Pew Charitable Trusts, said 44 medical schools now restrict their faculty members from being part of any pharmaceutical company’s “speaker’s bureau,” up from just four schools in 2008.

Beginning next year, a provision of the Affordable Care Act will require disclosure of payments or other gifts from drug makers or manufacturers of medical supplies.


Eastern Maine Medical Center in Bangor no longer accepts sample medications at its practices because of the possibility that doctors could end up prescribing a name-brand medication more often than an equally effective and less costly generic.

The hospital also requires full disclosure of any links to any pharmaceutical company whenever a doctor seeks to join, requests that a particular medication be added to the formulary, or gives a paid speech.

“We have tried hard to be transparent and to eliminate some of the effects of what we see as marketing by the pharmaceutical companies,” said Dr. James Raczek, senior vice president of operations and chief medical officer at Eastern Maine Medical Center.

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