Pfizer admits paying $35 million to doctors over last 6 months

By Dr. Ananya Mandal, MDApr 1 2010

Pfizer among other large pharmaceutical companies recently disclosed payments to doctors and other medical professionals for consulting and speaking on its behalf and also some sponsorship of clinical trials. On Wednesday in an announcement the company spokesperson revealed that they had paid a whopping $20 million to 4,500 doctors and other medical professionals in the last six months of 2009. Pfizer also accepted that they paid $15.3 million to 250 academic medical centers and other research groups for clinical trials in the same period. This disclosure is only about payments made within the US.

A spokeswoman for Pfizer, Kristen E. Neese, said that these disclosures were required by an integrity agreement that the company signed in August to settle a federal investigation into the illegal promotion of drugs for off-label uses. Dr. Freda C. Lewis Hall, Pfizer’s chief medical officer said that this disclosure and web portal was a part of “a march to disclosure” that the company started in 2002. Ms. Neese said that these disclosures improve transparency of conduct of the pharmaceutical companies.

The disclosures, which are posted on its website, www.pfizer.com/WorkingWithHCP, involve those who received payments, meals or non-monetary educational items worth $25 or more, according to Pfizer.

Three other ‘pharma’ giants Eli Lilly, Merck and Glaxosmithkline have already made such disclosures but have not revealed their role in clinical trials. From 20102 the pharmaceutical and medical services companies will have to make disclosures of payments to doctors of more than $10, with the first report available in 2013. The Physician Payment Sunshine Act was passed as part of health care reform. Some states also have disclosure laws.

This disclosure according to M Neese also includes payments made to academic centers, nurse practitioners and physician’s assistants. This is something that the Sunshine Law does not mandate. Further Pfizer claimed no imposing delay of up to four years on financial support for clinical trials.

Dr. Marcia Angell, former editor of The New England Journal of Medicine said, “If they’re doing that — it would amaze me if they did, but if they are — that’s great.” But she also said that these amounts seem too low. “I can’t help but think something has escaped,” she said.

This disclosure has raised issues of conflicts of interest in medicine.

“I think it’s a good thing to do, but I put absolutely no trust in what drug companies voluntarily disclose to the public when those things are unaudited,” said Eric G. Campbell, lead author of a 2007 study of physician-industry relationships published in The New England Journal of Medicine.

It is illegal to promote drugs for uses that are not cleared by the US Food and Drug Administration. Pfizer last September was accused of this offence and fined. In fact in 2004 Pfizer had pleaded guilty for improper sales tactics and its practices. This disclosure is thus taken with a pinch of salt by many.