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Vt. doctors get $2.9M cash, gifts from drugmakers

By John Curran
Associated Press Writer / April 16, 2009
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MONTPELIER, Vt.—The nation's pharmaceutical makers spent more than $2.9 million on Vermont's doctors, hospitals and universities to market their products in the last fiscal year, according to a report issued Wednesday by the state attorney general's office.

That's down slightly from the previous year, but Attorney General William Sorrell says he's not sure if the drug companies are tightening their belts or if they want to avoid public scrutiny for the payments, whose recipients aren't identified.

The report shows 78 companies spent the money in the year ending July 1, 2008. By law, the companies have to report their spending on consulting and speakers' fees, travel expenses, gifts and other payments to or for physicians, hospitals, universities and others authorized to prescribe drugs.

The cash payments are made directly to health care providers, Sorrell said.

"It's `I pay you money to give me feedback on how your patients react to my drugs,' `I give you free samples that you can prescribe to your patients,' `I'll pay you a consulting fee or take you to dinner or pay for you to take a trip someplace to hear lectures or presentations on how this drug works or how effective it is for various conditions,'" Sorrell said.

The Pharmaceutical Marketing Disclosure Law, adopted in 2002, requires drugmakers to report their spending by Dec. 1 and the attorney general to issue a report summarizing them. At least four other states have such disclosure laws, but the report released Wednesday dealt only with Vermont. The disclosures don't include money spent on advertising.

The industry says that the money helps pay for education programs about drugs for doctors and patients and that the drug companies develop some of their medicines using feedback from prescribers and users.

Among the findings of the report released Wednesday:

--Eli Lilly and Co., Pfizer Inc., Novartis Pharmaceuticals Corp., Merck & Co. and Forest Pharmaceuticals Inc. were the biggest spenders.

--25 doctors and nurses each got more than $20,000 in cash or benefits from the companies, 10 got more than $50,000 and one psychiatrist took in $112,000.

In the year ending July 1, 2007, 84 companies had reported spending $3.1 million, following a larger trend in which the number of companies spending the money increases but the overall amount decreases. From 2004 to 2008, the number of manufacturers reporting climbed 40 percent but the amount they spent dropped by 30 percent.

The report doesn't identify the recipients of the money, an exemption at the heart of a bill before the state legislature. The bill would eliminate the drug companies' ability to claim "trade secret" in providing the information to the state but barring the state from releasing it to the public.

Sorrell said more than 80 percent of the expenditures analyzed for the report claimed the trade secret designation. He said consumers would be better off if that weren't an option so people would know if a health care provider recommending a drug had been paid by its manufacturer.

"If I was a patient or one of my kids was a patient, and my doctor was telling me, `You ought to try drug X,' I would like to know that my doctor received $40,000 from the company that manufactures and markets this drug," he said.

The Vermont Medical Society, a physician advocacy group, and the Vermont Psychiatric Association, an organization of psychiatrists, endorse the bill. They say it would improve patient confidence if the information were public.

The Pharmaceutical Research and Manufacturers of America, which represents drug companies, says much of the money goes toward helping doctors know when to prescribe a certain medication.

"An individual who's prescribing, particularly a new medication, needs to know when it should be used, what patient populations it should be used for, for what conditions and when it should not be used," said Marjorie Powell, senior assistant general counsel for the group, a trade association.

The group opposes elimination of the exemption, saying it would allow competitors to know their trade secrets.

"The amount I'm spending on how to improve a product would be valuable information to a company that's considering making a competing product," Powell said.

She said the reason for the trade secret designation wasn't to hide anything from patients.

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