Drug firm money not always disclosed by MDs

NEW YORK (Reuters Health) - Laws that mandate the disclosure of payments to physicians by pharmaceutical companies provide limited public information, according to a new report.

At present, only five states and the District of Columbia have legislation requiring payment disclosure. And among these states, only Minnesota and Vermont require that the information be made available to the public.

In the current study, reported in the March 21st issue of the Journal of the American Medical Association, Dr. Joseph S. Ross, from Mount Sinai School of Medicine in New York, and colleagues examined the accessibility and the quality of information provided by the disclosure laws in Minnesota and Vermont.

The analysis included data from January 2002 to December 2004 in Minnesota, and from July 2003 to June 2004 in Vermont.

The researchers found that obtaining the payment information was not easy. In Vermont, extensive negotiation with the Office of the Attorney General was needed, while in Minnesota, manual photocopying of individual disclosure forms at the State Board of Pharmacy was required.

Missing disclosure information was common in both states.

In Vermont, 61 percent of payments were not released to the public because the drug companies classified them as revealing trade secrets and 75 percent of disclosed payments lacked information to identify the recipient.

In Minnesota, just 25 percent of drug companies reported payment information in all three years of the study.

Quite large payments to physicians were commonplace, the report indicates. In Vermont, 2416 of the 12,227 payments studied were each at least $100, amounting to a total of $1.01 million; the range was between $100 and $20,000, and the average payment was $177.

In Minnesota, large payments were even more common: 6238 out of 6946 payments were at least $100 (ranging up to $922,239, with an average payment of $1000), and these amounted to $22.39 million.

In a related editorial, Dr. Troyen A. Brennan, from Aetna Inc. in Hartford, Connecticut, and Michelle A. Mello, from the Harvard School of Public Health in Boston, comment that pharmaceutical companies' "primary commitment is to create shareholder value, not maintain an altruistic commitment to patients."

"But at some point, the leadership of the pharmaceutical industry and their board of directors must begin to recognize that growing public and professional mistrust could substantially detract from that value."

SOURCE: Journal of the American Medical Association, March 21, 2007.