Dollars for Docs

From ProPublica

Pharmaceutical and medical device companies are now required by law to release details of their payments to a variety of doctors and U.S. teaching hospitals for promotional talks, research and consulting, among other categories. Use this tool to search for general payments (excluding research and ownership interests) made from August 2013 to December 2015.

Also: Top 50 Companies - Click on a company to see how its payments break down by drug, device or doctor. Or see all companies.

And more...

That website John Oliver told you about: how much money Big Pharma has given your doctor?

On This Week Tonight, watch John Oliver eviscerate the stunningly corrupt practices of Big Pharma. This IS journalism. In the piece, he directs people to Open Payments, which is "a federal program that annually collects and makes information public about financial relationships between the health care industry, physicians, and teaching hospitals.

"The Centers for Medicare & Medicaid Services (CMS) collects information from manufacturers of drugs and devices about payments and other transfers of value they make to physicians and teaching hospitals. These payments and other transfers of value can be for many purposes, like research, consulting, travel, and gifts. CMS will be making this data publicly available each reporting year.

In other words, in the words of Mark Evanier, "you can look up your doctor and see how much loot he's taken and from whom."

Let’s Stop Pretending the Death Penalty Is a Medical Procedure

An editorial from Scientific American:

The idea of testing how to most effectively kill a healthy person runs contrary to the spirit and practice of medicine. Doctors and nurses are taught to first “do no harm”; physicians are banned by professional ethics codes from participating in executions. Scientific protocols for executions cannot be established, because killing animal subjects for no reason other than to see what kills them best would clearly be unethical. Although lethal injections appear to be medical procedures, the similarities are just so much theater.

Yet even if executions are not medical, they can affect medicine. Supplies of propofol, a widely used anesthetic, came close to being choked off as a result of Missouri's plan to use the drug for executions... The manufacturer feared that if the drug was used for lethal injection, E.U. regulators would ban all exports of propofol to the U.S....

Propofol is the most popular anesthetic in the U.S. It is used in some 50 million cases a year—everything from colonoscopies to cesareans to open-heart surgeries—and nearly 90 percent of the propofol used in the U.S. comes from the E.U. After 11 months, Missouri relented and agreed to return the drug.

Such incidents illustrate how the death penalty can harm ordinary citizens.

Health stats: medical visits, heart disease, Rx, C-sections, more

From the Agency for Healthcare Research and Quality

Dental Expenditures in the 10 Largest States, 2010
Estimates of Health Care Expenditures for the 10 Largest States, 2010
Heart Disease Among Elderly Americans: Estimates for the U.S. Civilian Noninstitutionalized Population, 2010
Heart Disease Among Near Elderly Americans: Estimates for the U.S. Civilian Noninstitutionalized Population, 2010
MEPS HC-144B: 2011 Dental Visits
MEPS HC-144C: 2011 Other Medical Expenses
MEPS HC-144H: 2011 Home Health File
Origin of Adverse Drug Events in U.S. Hospitals, 2011
Overview of Children in the Emergency Department, 2010
Prescription Drug Expenditures in the 10 Largest States, 2010


National Center for Health Statistics

Births: Final Data for 2011
Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996–2011
Disability Questions Tests 2012 File

Promotion of Prescription Drugs to Consumers and Providers, 2001–2010

Pharmaceutical firms heavily promote their products and may have changed marketing strategies in response to reductions in new product approvals, restrictions on some forms of promotion, and the expanding role of biologic therapies.

Total promotion peaked in 2004 at US$36.1 billion (13.4% of sales). By 2010 it had declined to $27.7B (9.0% of sales). Between 2006 and 2010, similar declines were seen for promotion to providers and direct-to-consumer advertising (both by 25%). DTCA’s share of total promotion increased from 12% in 2002 to 18% in 2006, but then declined to 16% and remains highly concentrated. Number of products promoted to providers peaked in 2004 at over 3000, and then declined 20% by 2010. In contrast to top-selling small molecule therapies having an average of $370 million (8.8% of sales) spent on promotion, top biologics were promoted less, with only $33 million (1.4% of sales) spent per product. Little change occurred in the composition of promotion between primary care physicians and specialists from 2001–2010.
Conclusions

These findings suggest that pharmaceutical companies have reduced promotion following changes in the pharmaceutical pipeline and patent expiry for several blockbuster drugs. Promotional strategies for biologic drugs differ substantially from small molecule therapies.

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