Wednesday, June 26, 2013

Raking it in...

ProPublica's recent report 'Top Medicare Prescribers Rake In Speaking Fees From Drugmakers' looked at pharma payments to physicians, honing in on Forest Laboratories and its blood pressure medicine Bystolic. The study marked "... the first time anyone has matched payment data made public by drug companies with physician prescribing records from the Medicare drug program, which covers about 1 out of every 4 prescriptions in the U.S..."

The article strongly implies that there is correlation, if not actual causation, between the speaking fees and other payments made, and the prescriptions written... It states "... Now, data obtained and analyzed by ProPublica suggest another factor in Bystolic's rapid success: Many of the drug's top prescribers have financial ties to Forest.

At least 17 of the top 20 Bystolic prescribers in Medicare's prescription drug program in 2010 have been paid by Forest to deliver promotional talks. In 2012, they together received $283,450 for speeches and more than $20,000 in meals.

Nearly all those doctors were again among the highest prescribers in 2011, the most recent year for which Medicare data are available..."  This, along with the "rake in" of the title are clearly meant to convey this impression.

OK, so this blogger actually believes in the position that would seem to be the one held by Dr. Nissen of the Cleveland Clinic i.e. that physicians should take no money from pharmaceutical companies. However, the numbers reported here are pretty meaningless and show next to nothing - rather than a (presumably) damning "...17 of the top 20 Bystolic prescribers in Medicare's prescription drug program in 2012... received $283,450 for speeches and more than $20,000 in meals..." based on the numbers in the table that accompanied the article one could as easily say "...almost half of these prescriptions were written by eight prescribers, who received a grand total of $14,500 between them!" Rather less "sexy."  There appears to be no correlation at all between the amounts of payments made and the number of prescriptions written.

Rather 'weak tea' here... Surely there are more robust numbers out there!

Note: If you click on one of the links, you see the information below regarding other Forest products. This could well explain the variance in pay among the prescribers listed... in theory the prescribers receiving higher fees while writing fewer Bystolic prescriptions could well also be among the top prescribers of a number of the other Forest products... The article lists 2012 speaking fees received from Forest, it does not say these were uniquely for speaking about Bystolic. Of course this would beg the question of why, if Dr. Reznik decided to "rake in" the money for prescribing Forest's Bystolic, why would he not do the same for their other products and thus "rake in" more than a measly $3,750? By focusing only on the Bystolic numbers and by presenting this uni-dimensional case, ProPublica has done the public a disservice. A 'lazy' article indeed.

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