Mass. posts industry payments to health care providers

Industry payments to physicians have come under increasing scrutiny because of critics' concerns that the money influences doctors to prescribe newer and more expensive medications, helping to drive up the cost of health care. But the companies and many doctors say that physicians should work closely with drug and device companies to help develop new treatments and educate their colleagues -- and that it's only fair they be paid for their time.

A number of other states require companies to disclose certain payments to medical providers, but it is not possible to compare the amount and number of payments made to Massachusetts providers to those in other states, because no other state is publicly reporting payments in such detail. A growing number of pharmaceutical and device companies -- some as part of settlements with federal prosecutors investigating inappropriate marketing -- have started listing money paid to physicians on their websites, but they do so for a limited number of categories.

The physician receiving the most during the six-month period, according to a DPH analysis, is Dr. Mary Ann Asbell in Cambridge, who was paid $194,275 by Genzyme Corp. in Cambridge for unspecified "bona fide services", a category that includes speakers bureaus and consulting. However, she is not listed currently as a licensed doctor in Massachusetts, according to the Board of Registration in Medicine.

The other top four doctors were Dr. Charles M. Gibson, a Boston cardiologist affiliated with Beth Israel Deaconess Medical Center, paid $188,617 by six companies; Dr. Stephen John Ferzoco, a general surgeon affiliated with Brigham and Women's Hospital, paid $187,443 by LifeCell Corp. of New Jersey; Dr. Lawrence M. Dubuske, a former Brigham allergist, paid $153,385 by five companies; and Dr. Stephen B. Murphy, an orthopedic surgeon affiliated with New England Baptist Hospital and Beth Israel Deaconess, paid $149,996 by Wright Medical Technology of Tennessee. More than 5,000 doctors received payments.

The Globe reported earlier this year that DuBuske resigned from Brigham and Women's largely because of a new ban on promotional speaking by doctors adopted by the Brigham's parent company, Partners HealthCare.

After doctors, registered nurses received the next most money, $1.2 million, followed by pharmacists, $623,360, and dentists, $516,656.

Compensation for participating in speakers bureaus, consulting, and other "bona fide services" was by far the largest category of payments, accounting for almost $18 million.

Consulting with industry to develop new treatments is considered part of a physician’s role. But participating in speakers bureaus is controversial. Bureau speakers typically show groups of doctors company-created or approved slide presentations about specific drugs or diseases treated by a company’s products. Many of these talks, often held at fancy restaurants, have been moved out of state since last year, when Massachusetts banned doctors from eating the free dinners. Companies defend speakers bureaus as an important tool for educating doctors.

Elizabeth Daake, policy and planning director for the state's Bureau of Health Care Safety and Quality, said that since the disclosure requirement is new she wasn't sure what to expect in terms of the amount and types of payments. But she said this first database gives the state a baseline that will allow it to measure the impact of the growing number of hospital and medical school policies banning certain industry payments to health care providers. Many institutions are cracking down on doctors' relationships with companies for fear they can create bias, or at least the perception of bias, when it comes to prescribing drugs or recommending treatments.

"It will be really interesting to see what this shows going forward,'' Daake said. "I wouldn't be at all surprised if we see a decline (in payments). Public reporting itself draws attention to it.''

The Department of Public Health originally listed a University of Massachusetts Medical School psychologist as the health provider who had received the highest payment -- $250,000. After inquiries by the Globe and a flat denial by the psychologist, the state acknowledged it was an error. The state this afternoon removed the psychologist's name from its database and Boston.com also has removed her name from its story.