When device manufacturers and drug companies hand out gifts, perks and freebies to medical professionals, some providers fare far better than others, according to an examination of more than 160,000 payments made to doctors, dentists, chiropractors and podiatrists in Oregon.
The data, compiled by investigative journalists at nonprofit ProPublica, and analyzed by The Lund Report with the assistance of software developer Sarah Fullmers, sheds light on more than $42.8 million spent in Oregon by drug companies and device makers. In earlier looks at the data, we named the companies that were spending these funds, and identified which products they were trying to promote. Click here to read that story. A second story in the series looked at payments to teaching hospitals.
Today, we’re examining how different types of medical providers fare.
Extensive research has documented the subtle and direct ways Big Pharma spending influences medicine; physicians who are treated to lunch, offered free training or otherwise paid by pharmaceutical companies have repeatedly been shown to prescribe more of those companies’ drugs. In a paper in JAMA Internal Medicine, researchers argued that these relationships distort how diseases are researched, defined, prevented and treated – not always to the benefit of patients.
The Physician Payment Sunshine Act, passed alongside the Affordable Care Act as part of Barack Obama-instigated healthcare reform, required pharmaceutical and medical device companies to publicly report these payments starting in August 2013. Industry officials defend the money they spend, telling ProPublica that meetings with doctors allow them to keep in touch with the needs of local communities, and that other funds compensate medical providers for assisting with research, or for providing or attending training.
The data show that more than 9,652 medical professionals in Oregon have accepted at least one gift or payment from 706 distinct medical device or pharmaceutical companies since data tracking began.
These payments are broken out by six types of professional certification: chiropractor, doctor of dentistry, doctor of optometry, doctor of osteopathy, doctor of podiatric medicine, and medical doctor.
The big picture breakdown of how much each category of provider received from
- Chiropractors – only 55 gifts, payments or donations were accepted, with the average payment being $63.82, for a total of $3,510.37.
- Doctors of dentistry – 7,577 gifts, payments or donations were accepted, with the average payment being $340.10, for a total of $2.6 million.
- Doctor of optometry – 4,251 gifts, payments or donations were accepted, with the average payment being $197.11, for a total of $837,910.34.
- Doctor of osteopathy – 12,666 gifts, payments or donations were accepted, with the average payment being $72.32, for a total of $915,970.49.
- Doctor of podiatric medicine - 1,096 gifts, payments or donations were accepted, with the average payment being $91.42, for a total of $100,198.50.
- Medical doctor – 133,484 gifts, payments or donations were accepted, with the average being $204.80, for a total of $27.3 million.
In addition to these figures, another 1,777 gifts or payments were made to medical clinic or professionals whose specialty was not listed in the database – cumulatively valued at $53.9 million.
The data reveals a huge range in how drug companies and medical device manufacturers spend money on medical providers. Funds are broken down into categories: spending on accredited training, charitable contributions, education, food and beverages, gifts, grants, honoraria, nonaccredited training, ownership of investment interests, promotional speaking fees, royalty or licensing payments, space rental or facility fees, and travel and lodging.
The types of payments that professionals accept also vary within these categories.
Chiropractors, who received less from industry than other professional groups, got all of their gifts or payments in two categories: $178.50 spent on education, and $3,331.87 spent on food and beverages.
Dentists received $107,600 in accredited training, $144.72 in charitable contributions, $684,923.57 in consulting fees, $110,443.70 in education, $2,119.29 in entertainment, $213,739.17 in food and beverages, $254,599.74, in gifts, $18,570.36 in grants, $7,250 in honoraria, $103,530.33, in nonaccredited training, $118,920.16 in promotional speaking fees, $745,778.83, in royalties or licensing fees and $209,303.86 in travel and lodging.
Doctors of optometry received $2,934.84 in charitable contributions, $204,439.71 in consulting fees, $8,677.99 in education, $524.15 in entertainment, $122,713.09 in food and beverages, $3,314.96 in gifts, $4,000 in honoraria, $5,732.20 in nonaccredited training, $130,370.12 in promotional speaking fees, $219,017.36 in royalties or licensing fees and $136,185.92 in travel and lodging
Doctors of osteopathy received $250 in charitable contributions, $144,778.06 in consulting fees, $41,202.34 in education, $137.47 in entertainment, $212,253.64 in food and beverages, $256.17 in gifts, $1,000 in grants, $36,229.87 in honoraria, $600 in nonaccredited training, $335,945.00 in promotional speaking fees and $143,317.94 in travel and lodging.
Doctors of podiatric medicine received $24,906.20 in consulting fees, $10,370.11 in education, $37,904.47 in food and beverages, $104.35 in gifts, $1,000 in honoraria, $1,640.63 in promotional speaking fees and $24,272.74 in travel and lodging.
Medical doctors received $9,259.57 in accredited training, $381,831.76 in charitable contributions, $7,679,150.51 in consulting fees, $489,882.01 in education, $3,121.59 in entertainment, $2,776,573.27 in food and beverages, $35,367.43 in gifts, $303,030.52 in grants, $702,781.70 honoraria, $320,754.25 in nonaccredited training, $411,915.14 in ownership or investment interest, $6,724,373.76 in promotional speaking fees, $3,598,433.43 in royalties or licensing fees and $3,901,343.11 in travel and lodging.
In an upcoming story, The Lund Report will dig deeper to name the individual providers that accepted the largest gifts, payments and other support from drug makers and device manufacturers.
Reach Courtney Sherwood at [email protected].