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Drug firms disclose spending on meals

By Liz Kowalczyk
Globe Staff / September 11, 2011

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Drug makers that recently revealed their financial arrangements with physicians are starting to publicly report how much they spend on treating them to lunch and dinner.

Pfizer, the world’s largest pharmaceutical company, for example, spent more than $200,000 last year to feed almost 3,000 Massachusetts doctors and other health care providers, even with the state’s recent restrictions on industry-funded meals, according to a new analysis of data posted on the company’s website.

Pfizer spent about $47,000 in the first quarter of this year on meals to Massachusetts providers.

Some of those meals were bought for doctors who work as consultants for Pfizer or who moonlight as speakers for the company’s products. But other meals were purchased for doctors who did no work for Pfizer but simply listened to a talk about a product or disease during the meal.

Pfizer also includes in its total some meals purchased for nurse practitioners and physician assistants, who, like doctors, can prescribe drugs.

Pfizer reported spending as little as $10 on some doctors, and hundreds of dollars for others, and in a few cases, several thousands dollars.

Pfizer spent $3,266 last year on meals for Dr. Stanley Nasraway, director of the surgical intensive care unit at Tufts Medical Center - more than any other Massachusetts doctor. A hospital spokeswoman said that Nasraway gave 64 out-of-state talks for Pfizer, many of which were at dinnertime and involved a restaurant meal costing about $50.

The amount companies spend on meals is relatively small when compared with direct payments made to doctors for speaking and consulting. Nasraway, for example, earned $150,900 speaking for Pfizer last year. But it falls in an area that is the target of growing restrictions by regulators and at some academic medical centers and medical schools because of past abuses. Those involved drug companies paying for lavish steak and lobster dinners for physicians, sometimes at seaside resorts, to encourage them to prescribe their products.

The Boston Globe and ProPublica, a nonprofit online investigative journalism organization, recently analyzed payments posted on the websites of 12 drug makers. The analysis found that payments to doctors in Massachusetts for promoting a company’s drugs in speeches to colleagues appear to be falling.

It is impossible to compare spending on recent meals to prior years because companies have just started reporting that level of detail. Only two other companies disclosed spending on meals for all of 2010 - Cephalon, which spent about $18,000 in Massachusetts, and Johnson & Johnson, which spent about $3,000.

Under federal law, all drug and medical-device firms will be required to publicly report all payments to physicians, including meals, beginning in 2013. Massachusetts, which required similar disclosure starting in July 2010, expects to release its first full year of data, for 2010, at the end of this year.

That report will provide even more detail than what is available on company websites, such as the number of meals each physician ate, so it is possible to estimate cost per meal. Now, companies generally report on their websites one aggregate amount per doctor, so it is difficult to determine whether an individual meal was lavish.

Massachusetts regulations that took effect in July 2009 prohibit doctors and certain other providers from accepting meals unless they are provided in the physician’s office or at a hospital. The meals must be “modest’’ and part of a formal educational presentation made by the company. The regulations apply to Massachusetts-licensed doctors even when they are attending an event out of state.

Pfizer spokeswoman Kristen Neese said the average cost of a meal provided in a doctor’s office is $11, while meals provided during educational programs in restaurants average about $65.

“Health care professionals have very limited time and it is often convenient for them to attend meetings or speak with biopharmaceutical representatives during mealtimes,’’ she said.

Madeleine Biondolillo , director of the state Bureau of Health Care Safety and Quality, said it is difficult to police where doctors are eating industry-funded meals. The health department reports suspected violations to the Attorney General Martha Coakley’s office for investigation.

Coakley’s staff has fined two companies, Analogic Corporation in Peabody and Lantheus Medical Imaging in Billerica, for improperly providing meals to health care workers in restaurants.

Several legislators have filed bills that would repeal the meal ban, saying the law has hurt business in the state’s restaurants at a time when they need it most.

But Brian Rosman, research director at Health Care for All, a consumer group that championed the law, said the state is collecting more money in meals taxes, indicating that “restaurants are doing better than ever.’’

“We think doctors should base their decisions on what is the best drug for the patient,’’ he said “and not be influenced by insidious marketing techniques.’’

Liz Kowalczyk can be reached at kowalczyk@globe.com.

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