Secret drug company payments to doctors remain legal in 48 states

By David Gutierrez

Only five states and the District of Columbia require that pharmaceutical companies report gifts they make to doctors, and even in these jurisdictions the laws are so poorly enforced that the details of these transactions remain a de facto secret, according to a study published in the Journal of the American Medical Association.

Researchers examined public records from Vermont and Minnesota, the only two states that require disclosure by pharmaceutical companies and make that data available to the public. By studying the data from 2002 to 2004, the researchers hoped to gain a better understanding of how money moves from the pharmaceutical to the medical industry.

“What we really found was laws aren’t working,” said study author Joseph Ross, of the geriatrics department of Mount Sinai School of Medicine in New York.

The researchers found that while reported payments were quite high, the details of those transactions were not available. In other cases, reported payments were so low as to be suspicious. For example, GlaxoSmithKline claimed zero dollars spent in Vermont in the time period studied, yet the state attorney general listed the company as making more payments than any other. In Minnesota, Amgen recorded zero dollars in payments in 2002 or 2004, but more than $4 million in 2003.

Part of the reason for this inconsistency is that gifts of drugs or items not yet on the market can be classified as “trade secrets” and not reported. But Ross believes that this loophole is being exploited.

“To designate every payment made as a trade secret … seems improbable,” he said.

Pharmaceutical companies have been known to give doctors extravagant gifts including all-expense-paid vacations or gourmet dinners as part of their marketing campaigns. According to Dr. Harlan Krumholz, an associate professor at the Yale University School of Medicine, this presents a conflict of interest that the public should know about.

Ross agrees. “If both parties think this payment is appropriate, then this information should be made available to the public,” he said.

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