ProPublica has developed a niche over the past couple of years through its “Dollars for Docs” database. As we have covered extensively since the launch of that campaign, ProPublica aggregated the payment reporting data of 15 manufacturers who were reporting their physician payments publicly—either as a requirement of a corporate integrity agreement (CIA) or voluntarily—and then created a searchable website.
Last week, ProPublica stepped out of its comfort zone and published a “Reporting Recipe” in anticipation of the Sunshine Act: “With more data on relationships between doctors and drug companies soon to be released, here are some ways journalists can use this information.” The article sheds light on how the media will use the payment data from the Sunshine Act when CMS makes Open Payments public.
“We thought this would be a good time to take a step back and explore the types of stories journalists can write now and in the future using payment data,” ProPublica states.
- Who are the highest-paid speakers/consultants in your area?
As ProPublica itself has done, the website advises journalists to look at the top paid doctors.
- Who is receiving payments/who has stopped?
ProPublica notes that Dollars for Docs includes data for some companies dating back to 2009. “That presents a chance to look at changes over time: which doctors have started accepting funds from a company, which continue to accept funds and which no longer do so—and why.” While ProPublica has indeed scared doctors from accepting speaker payments, is this a benefit to patients? The majority of doctors select speaking arrangements in which they truly believe in the benefit of the drug they speak about. ProPublica indeed may turn away the best educators.
- What are the rules at your local medical schools—and are faculty members following them?
Because of all the types of transfers of value, this will be a hard one for doctors. Many reported items will not be on their personal radar and may be in violation of their universities policies.
- Are the top-paid doctors in your area actually “experts”?
ProPublica provided some insight into what “disqualifies” someone as an expert: not being “experts in the traditional sense,” not working at academic medical centers, not having research publications, not in specialty societies, being disciplined by a medical board.
- How much do drug company dinners cost?
ProPublica advises journalist to look at both the number of meal and the aggregate total cost of the meals a speaker receives.
- Do big prescribers of brand-name drugs in Medicare Part D have financial relationships with the makers of those drugs?
As we have reported, ProPublica has obtained access to the Centers for Medicare and Medicaid (CMS) database for Part D prescribers. In its article, ProPublica took aim at the highest prescribers of Forest Laboratories’ drug, Bystolic, and matched those numbers up with payments of speaker fees to those prescribers. The two highest prescribers received relatively modest 2012 speaker fees of $3,750 each.
- Do doctors have overlapping relationships with a company?
Here, ProPublica is focused on company researchers who explain their research to other interested doctors. Ironically, the recently published article sets its sites on antibiotic research, a vital area of study. The Food and Drug Administration Safety and Innovation Act (FDASIA) even includes an important section, “Generating Antibiotic Incentives Now” (GAIN), which seeks to encourage this research.
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While the ProPublica story does prepare companies and doctors for the news stories to come, this article fails to portray these payments in an objective manner. It will be interesting to see how many news outlets just cut and paste ProPublica’s questions without asking any questions themselves.
Unfortunately, we worry that newspapers will simply attack the nation’s top physicians—who educate their peers, conduct clinical research, and consult with industry to ensure that Americans have the most advanced treatments and medicines.