New Documents Show How Drug Companies Targeted US Doctors to Increase Opioid Prescriptions
Charles Ornstein (ProPublica) 20 May 2022
This story was originally published by ProPublica.
A trove of documents published as part of a legal settlement offers an unvarnished look inside the financial relationships between pharmaceutical companies and the medical community — from the perspective of drug companies themselves.
Twelve years ago, ProPublica set out to build a first-of-its-kind tool that would allow users, with a single search, to see whether their doctors were receiving money from an array of pharmaceutical companies.
Dollars for Docs generated a huge rush of interest. Readers searched the database tens of millions of times to see if their doctors had financial ties to the companies that made the drugs they prescribed. Law enforcement officials used it to investigate drug company marketing, drug companies looked up their competitors and doctors searched for themselves.
A trove of recently released documents offers the public an unvarnished look inside those relationships from the perspective of drug companies themselves.
The material shows company officials worked to deflect the media scrutiny even as they sought to take advantage of relationships that they had built with doctors they were paying significant sums of money.
The documents were published online by the University of California San Francisco and Johns Hopkins University and became available as a result of drugmakers settling lawsuits against them for their role in the opioid crisis. These are exactly the kinds of documents we wanted to see when we started working on the Dollars for Docs series in 2010, but of course, no one was willing to show them to us.
Reading them should give patients even more pause about the financial entanglements their doctors have with the drug industry and spur them to ask questions (we have some ideas about specifics below).
The Washington Post mined the records and found that more than a quarter of the 239 medical professionals ranked as top prescribers by opioid maker Mallinckrodt Pharmaceuticals in 2013 “were later convicted of crimes related to their medical practices, had their medical licenses suspended or revoked, or paid state or federal fines after being accused of wrongdoing.” The article was replete with examples of doctors whose problems were well known but who were targeted anyway by sales representatives.
This was a familiar finding. Back in 2010, we found that hundreds of doctors paid by drug companies to promote their drugs had been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.
The document trove included some mentions of our earlier work.
Among them: a 2010 email from a senior director of global compliance at Cephalon Inc., a small drug company that was subsequently acquired by Teva Pharmaceuticals.
In the message, the director notes that what ProPublica found — Cephalon had paid doctors who had been sanctioned by their states to deliver promotional talks on its behalf — was, indeed, true, and that the company was undertaking a review of all of its doctors in light of our findings.
Another document included a list of those doctors.
And there’s a 2017 presentation from an official at Mallinckrodt about the state of transparency around payments to doctors. It called ProPublica the “most thorough and vocal media source re: Open Payments data. Their analyses and searchable database are likely the go-to place for anyone wanting to do a comparison of companies and physicians.”
Our Dollars for Docs data often was picked up by news outlets across the country, including WNBC-TV in New York City. In one document, a spokesperson for the company Covidien was happy that the reporter had not asked about Exalgo, a new opioid made by the company. “Based on our conversation, I do not believe that the reporter is aware of Exalgo — and I am certainly not planning to make him aware,” she wrote in 2013.
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