Area physicians accept thousands from drug companies for speaking, other expenses

In 2010, pharmaceutical company Novartis paid Grand Forks neurologist Dr. Matthew Roller $4,550 to talk about its drug Gilenya, the first oral medication approved for treating multiple sclerosis.

Before that medication, multiple sclerosis was treated via injection - a method patients weren’t fond of, according to Roller.

“They rejoiced when (Gilenya) came out,” Roller said, adding the one-hour sponsored talk gave him an opportunity to discuss the drug and its side effects in detail - a feat not easily accomplished during an office visit.

Roller’s payment was among more than 250 made to doctors or health organizations listed as practicing or located in Grand Forks during a time period spanning 2009 to 2012.

The payments from drug and medical device companies to doctors or research centers were for speaking at conferences, conducting research, consulting and covering meals and travel expenses. Payments totaling more than $10 are required to be reported.

At least 160 doctors or organizations operating in the city received more than $275,000 in payments during that four-year period, according to a Herald analysis of data compiled by nonprofit journalism organization ProPublica.

Such transactions between doctors and companies are legal but beginning to decline as scrutiny of the practice increases and mandates from the Physician Payment Sunshine Act - part of the 2010 health reform law - require all of these payments be publicly disclosed.

For instance, Novartis spent less on speakers in 2012 than it did between October 2010 and September 2011, shrinking its total payments from $24.8 million to $14.8 million.

An online database listing payments for all companies is expected to be running no later than Sept. 30, 2014.

“Patients will have access and should have access to that information,” Roller said. “If they want to choose a physician based on that information, I think that is appropriate.”

Top earners

In North Dakota, companies spent about $5.5 million through more than 3,500 payments from 2009 to 2012, according to ProPublica’s database.

The database contains about 2 million records from 15 pharmaceutical companies. Those companies’ market share makes up less than half of the overall industry.

Even with a total of $12,097 in payments disclosed among locations in North Dakota and Minnesota, Roller was by no means the area’s top earner.

During that time period, five physicians and one health organization in Grand Forks and Devils Lake received more than $20,000 from drug companies.

Receiving the most was Dr. William Zaks, a endocrinologist for Altru in Grand Forks. He accepted 12 payments from three companies for speaking and meal expenses totaling $75,777. Zaks was not available to comment on the payments.

Altru’s Research Center received about $61,000 for research expenses. Research centers are often paid to test companies’ products to determine their effectiveness and any side effects.

The research center listed 18 clinical trials either accepting participants or in progress as of Friday.

Research is the foundation of medicine, according to Altru’s Chief Medical Executive Dr. Eric Lunn, but securing money for any type of research can be difficult as competition for funding sources such as grants has increased.

Though some trials like those occurring at Altru are sponsored by companies, Lunn said that shouldn’t affect the outcome.

“The results are the results,” he said.

In Fargo, the payment totals are higher and reached more than $1 million for research group Hoosier Oncology Group and Dr. Michael Lillestol, president of Lillestol Research.

Sixteen doctors or organizations in Fargo and West Fargo collected payments totaling more than $20,000. More than 900 payments ranging from $10 to $1.1 million were recorded from 2009 to 2012 in those cities.

Unbiased talks

Critics of the payments say doctors being compensated for activities such as speaking could affect what they include in their talks or even what types of drugs are prescribed or medical devices recommended to patients.

Because of that negative perception, Lunn said he hasn’t accepted drug company payments in 20 years.

“Whether it’s true or not, it looks like it could influence your talks,” he said.

Though Roller’s talk was sponsored by Novartis, he said regulations keep him and other speakers from delivering a biased presentation.

The presentations can take more than 20 hours of preparation including a legal and literature review and even speaker training, according to Roller and Lunn.

“These are the not the testimonials you see on TV at midnight,” Lunn said.

To Roller, educating patients is the focus these types of presentation and the question and answer sessions that usually follow. 

“Patients get to share their experiences (with multiple sclerosis). It’s helpful for us to hear and for other patients to hear as well,” he said. “It gives us a chance to talk about medicine in an arena outside of the examination room.”

While some speakers talk specifically about companies’ products, others are paid to talk at conferences or patient events may present general advancements in their fields. Some speakers also volunteer instead of taking payment.

The practice of receiving payments for drug companies has been winding down for years, but sometimes company money is still necessary to inform medical professionals and patients of research results and other medical advancements, according to Lunn.

“Knowledge is power,” Lunn said. “Sometimes it just comes down to who can pay for it.”

Online

To view payments made to doctors in any state, visit ProPublica’s online Dollars for Docs database at  http://goo.gl/XaXhfx  

Also check out Jewett's blog post featuring more local numbers not included in the story.