Physician Payment Sunshine: Eli Lilly Reports All Payments to Physicians

Continuing its commitment to transparency and integrity, Eli Lilly launched its physician payment registry for payments as low as $10, a website that enables visitors to search payments to individual U.S.-based physicians and the institutions or research organizations that receive payments on behalf of a physician.

Lilly was the first company (in 2004) to establish an online database of clinical trial results, and the first company (in 2007) to establish a public registry of grants and charitable contributions. And, in 2009, Lilly became the first company to report payments to physicians for speaking and advising services. Lilly strives to be a leading voice and example in transparency efforts in the biopharmaceutical industry.

The drug maker said that its website, which is in line with its corporate integrity agreement (CIA) with the U.S. government, aims to show how the company works with U.S. physicians and compensates them for their services and how these collaborations benefit patient care.

Eli Lilly Payment Registry

Payments are reported in several categories, including research-related payments, educational programs and other services, such as commercial consulting. The registry also discloses noncash forms of value provided (e.g., business meals), as well as travel expenses paid by Lilly when a physician is performing services for the company. The registry is organized in an easy-to-use manner.  You can sort payments by

•          Entity Paid 
•          Physician/Professional Paid
•          State; and
•          Total

Users can also download the full report, or type into a search box to look for specific names of practitioners or entities.

Eli Lilly noted that 63% of payments reported on the registry are related to research, including clinical studies for investigational medicines.  Without these collaborations, new medicines could never reach millions of patients that are suffering with diseases such as cancer, diabetes, depression, and Alzheimer’s.

Specifically, Lilly explained how much of the cost to bring a new medicine to patients—estimated by Tufts Center for the Study of Drug Development at $1.3 billion—is associated with large, global Phase III clinical studies.  Lilly noted that the company is only able to gather evidence to determine their medicines are safe and effective before it reaches the patients by collaborating with research institutions and physicians—called principal investigators—who enroll patients in these clinical studies and oversee their treatment.

Lilly explained that, when an institution participates in a clinical study, it incurs not only the costs commonly associated with treating a patient, but also additional costs related to testing (for example, MRIs, scans, blood work) that must be conducted to provide the information necessary to evaluate the potential medicine. Additionally, institutions and physicians sometimes incur expenses related to advertising required for patient recruitment into the clinical study, and they pay fees to independent regulatory review boards that oversee the study process. Lilly pays for these expenses because they are required by the study.

Lilly pay’s for other research and development work including: basic research conducted before studies begin in humans, consulting related to the clinical study design, and costs associated with clinical studies that are initiated by independent investigators.

Lilly’s clinical study payments are made to an institution such as a hospital or university or a principal investigator (physician overseeing patients in the study) to cover all these costs associated with the clinical study. In most cases, Lilly does not know the amount of compensation, if any, that the principal investigator receives from the institution for involvement in the study.

In addition, principal investigators, as well as physicians conducting educational programs, consulting, or other services to Lilly can and should be compensated at fair market value for their time and expertise.

To minimize taking time away from treating patients, Lilly may meet with practicing physicians during meal times and, in doing so, as a courtesy, occasionally provide them with meals. Lilly also reimburses physicians for reasonable expenses, such as meals, airfare or lodging, incurred while conducting business on behalf of Lilly.

For the period January 1 to March 31, 2011, Lilly’s payments (compensation, reimbursement, and costs associated with research and development) to physicians and institutions or research organizations totaled $48.1 million.

Discussion

On their new webpage, Eli Lilly noted that, “When doctors work together with the pharmaceutical industry, and patients benefit — because collaboration makes new medicines possible, delivers quality health education, and provides better insights into unmet patient needs.”

To achieve Lilly’s mission of helping people live longer, healthier, more active lives, Lilly collaborates with a variety of health care professionals and other external parties. Without their support and expertise, Lilly asserted that it “simply could not be successful in bringing new medicines to patients.”

In fact, to fulfill regulatory requirements for approval of medicines and proper education of prescribers regarding those medicines, Lilly asserted that it must work in partnership with physicians and other health care professionals.

Accordingly, Lilly acknowledged that the new registry “site is intended to share important background information on why these collaborations are essential and how they are structured, including information about the payments and other forms of non-cash value that Lilly provides to the physicians who work with us.

In creating this new registry and making it public, Lilly hopes to show Americans their commitment to disclosing their financial relationships with physicians to help earn Americans trust.

Conclusion

In announcing the payment registry, Lilly’s U.S. medical division VP Jack Harris, MD, asserted that, “When healthcare professionals work together with the pharmaceutical industry, patients benefit from our combined expertise.” Harris further recognized that, “through these collaborations, Lilly is able to develop innovative medicines, improve health education and better understand patients’ needs. Without our joint efforts, new medicines could never reach the millions of patients who need better treatment options for diseases, such as cancer, diabetes, depression and Alzheimer’s.”