Doctors' drug money

July 10, 2014
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Physicians have lots of ways to bring in money.

I noted one back in April, when I wrote about the million-dollar compensation packages being paid by Indianapolis-area hospitals to a handful of the physicians they employ. Most of those big pay packages went to high-dollar surgeons in such fields as orthopedics, cardiology and bariatric surgery.

But even physicians that don't do surgeries can tap into a healthy stream of revenue—from Big Pharma.

Indeed, Indiana physicians and research organizations reaped more than $25 million in payments from 15 pharmaceutical firms in 2012, according to the most recent data made available by the not-for-profit group ProPublica. Those 15 companies account for about 43 percent of the U.S. drug industry.

That money—which includes all payments of $250 or more—flowed to nearly 1,000 doctors, dentists, pharmacists and research organizations. But mostly the money goes to physicians.

Those physicians steadfastly deny that their prescribing patterns are influenced by any of this money, but the drug companies obviously believe otherwise--or else they wouldn't keep spending these large amounts.

Nearly one third of the drug money in Indiana came from right here: from Indianapolis-based Eli Lilly and Co. The nearly $7.3 million Lilly spent not only funded clinical trials and speaking fees for physicians, but also employed current and former clinicians, such as Dr. Blaine Farley, via the Indianapolis-based YourEncore organization.

New Jersey-based Merck & Co. Inc. and U.K.-based GlaxoSmtihKline plc, respectively, spent the second and third most in Indiana in 2012, among the 15 drug companies that publicly report their spending with clinicians.

Drug Spending in Indiana, 2012

The drug companies paid most of the doctors for consulting and giving speeches about their drugs, as well as for meals and travel cots while doing those things.

For example, Dr. Woodrow Corey, a cardiologist in Carmel, received $83,000 in speaking fees in 2012 from drug company Forest Laboratories Inc. Dr. Chris Bojrab, a Carmel psychiatrist, received nearly $70,000 in speaking fees from Forest, Pfizer Inc., Merck & Co. Inc. and Cephalon Inc.

Bojrab told me a few years ago that the speaking and consulting fees from drug companies run about 20 percent higher than what he would earn by spending the same amount of time seeing patients. But he said it's work that comes on top of his full days.

“It’s not uncommon for me to come home and spend three or four hours a night, just to work out the travel details,” Bojrab said, adding, “And it’s not like the work that you had to do goes away.”

 
“We’re certainly well-compensated for what we do,” Bojrab said of physicians who consult and speak for drug companies. He also speaks and consults for six other drug companies, including New York-based Pfizer Inc. and Japan-based Takeda Pharmaceuticals.
 
He estimated the pay is about 20 percent higher than what he could earn if he just spent the time seeing patients. But he also has to spend a lot of time coordinating his travel schedules and catching up on work he missed while away.
 
“It’s not uncommon for me to come home and spend three or four hours a night, just to work out the travel details,” he said, adding, “And it’s not like the work that you had to do goes away.” 
 
“We’re certainly well-compensated for what we do,” Bojrab said of physicians who consult and speak for drug companies. He also speaks and consults for six other drug companies, including New York-based Pfizer Inc. and Japan-based Takeda Pharmaceuticals.
 
He estimated the pay is about 20 percent higher than what he could earn if he just spent the time seeing patients. But he also has to spend a lot of time coordinating his travel schedules and catching up on work he missed while away.
 
“It’s not uncommon for me to come home and spend three or four hours a night, just to work out the travel details,” he said, adding, “And it’s not like the work that you had to do goes away.” 
 
“We’re certainly well-compensated for what we do,” Bojrab said of physicians who consult and speak for drug companies. He also speaks and consults for six other drug companies, including New York-based Pfizer Inc. and Japan-based Takeda Pharmaceuticals.
 
He estimated the pay is about 20 percent higher than what he could earn if he just spent the time seeing patients. But he also has to spend a lot of time coordinating his travel schedules and catching up on work he missed while away.
 
“It’s not uncommon for me to come home and spend three or four hours a night, just to work out the travel details,” he said, adding, “And it’s not like the work that you had to do goes away.” 

However, the biggest drug company payments go to physicians for doing research, such as performing clinical trials. Physicians at the Indiana University School of Medicine and its close affilaite, the Indianapolis-based Regenstrief Institute Inc., were the biggest winners in Indiana.

It's important to keep in mind that those physicians and clinicians are the heads of teams of researchers. So when you see Dr. Anantha Shekhar, a psychiatrist and administrator at the IU School of Medicine, getting more than $1.8 million from drug companies in 2012, it doesn't mean he took all of that home. He may have taken none of it home. The same goes for many of the other physicians on the list below.

All told, 43 clinicians around Indiana received at least $100,000 in drug company payments. You can see the full list here:

1. ANANTHA SHEKHAR, Indiana University,    $1,845,000
2. DOMENICK ZERO, Indiana University,    $1,833,624
3. JEFFERY MILLEMAN, Salus Research,    $1,367,681
4. JON DAVID DUKE, Regenstrief Institute,    $1,190,612
5. MARC BRIAN ROSENMAN, Regenstrief Institute,    $604,537
6. RICHARD SAINI, GoldPoint Clinical Research,   $508,252
7. PAUL RYAN MOE, Indianapolis psychiatrist,    $482,688
8. RAJ KISHORE MATURI, Indianapolis eye surgeon,    $442,287
9. BLAINE FARLEY, Indianapolis ER doctor,    $434,815
10. ELENA CHIOREAN, Indiana University,    $417,166
11. ANDERSON HARA, Indiana University,    $340,221
12. HILLARY H WU, Indianapolis oncologist,    $331,945
13. MARTIN FARLOW, Indiana University,    $325,822
14. PHILLIP D. TOTH, Midwest Institute for Clinical Research,    $296,790
15. RANDALL RAY STOLTZ, Covance Labs-Evansville,    $287,960
16. SCOTT FRETZIN, Indianapolis dermatologist, $270,688
17. NIZAR EL-KHALILI, Lafayette psychiatrist,    $265,760
18. TIM TABER, Indiana University,        $253,405
19. PREETHAM JETTY, cardiologist at Community Hospital-Anderson    $241,904
20. PARAS HARSHAWAT, Terre Haute psychiatrist,    $237,168
21. E. ANGELES MARTINEZ MIER, Indiana University,    $227,600
22. EMILY LIFFICK, Indiana University, $220,160
23. PAUL GENE BIONDICH, Regenstrief Institute,    $210,000
24. ARTIS TRUETT, Pedia Research LLC,    $201,156
25. LETHA LOUISE TETRICK, Indianapolis pediatrician, $198,089
26. NAVEED CHOWHAN, New Albany oncologist,    $198,013
27. HUBERT S REYES, Evansville family physician,    $191,436
28. CASSANDRA ELAINE CURTIS, Indianapolis sleep specialist,    $190,394
29. PAUL YIEN KWO, Indiana University,    $175,795
30. PATRICK J LOEHRER, Indiana University,    $170,248
31. KEN DAWES, Indianapolis dermatologist,    $164,866
32. ERIK ALLEN IMEL, Indiana University,    $164,770
33. DAVID M LOESCH, Indianapolis oncologist,    $158,223
34. JOHN HOWARD PRATT, Regenstrief Institute,    $149,364
35. ANA GOSSWEILER, Indiana University,    $146,063
36. LUKE PAUL AKARD, Indiana Blood & Marrow Transplantation,    $137,965
37. KATHY MILLER, Indiana University,     $135,942
38. MAJED KOLEILAT, Evansville allergist,    $127,556
39. MAQBOOL AHMED, Evansville hematologist,    $124,940
40. WILLIAM C. COLLIS, Fort Wayne cardiologist,    $123,400
41. GARY WATERMAN, Evansville dermatologist,    $112,882
42. JOHNNIE AYERS, Indianapolis family physician,    $111,825
43. AJAY D DESHPANDE, Terre Haute pulmonologist,    $103,107  

For the list of every entity that received drug money in 2012, check out this spreadsheet.

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  • Discrepancy
    These drs are leaders in their field. I find funny no other hospitals not included. We know their some highly paid specialists from st Vincent that should be here.
  • Research is expensive
    Why is this story not about "searching for new medicines is difficult and expensive. Industry works with academia and clinicians to educate about disease states and treatment options. Industry also partners with academia and clinicians to conduct clinical research to test potential treatment options. Medical education and clinical research are expensive endeavors. Academicians and clinicians are fairly compensated for their time, efforts, and expertise"? Instead, this article dangles the implication that companies are bribing doctors. If the reader goes past the headline and the first half of the article, they'll get to the part that talks about clinical trials. Is this responsible journalism?
    • To Don
      Many of these docs do work for hospital systems, but I generally did not list the hospitals unless the hospital was listed as a recipient of payments from the pharmaceutical firm. Also, I didn't list hospital systems outside the Indianapolis area, because I thought it would be extraneous detail to the bulk of my readers.
    • To John
      Whatever this money is used for, I think it's important for people to know how much of research and education are funded by pharmaceutical companies. I'm not saying there is something wrong with it, but it should be known.
      • Clarity
        A couple of issues need some clarification especially since my name was on the list. I am not sure how this information was obtained and from where. For me, the amount was incorrect to begin with and the money does not come to me personally. I am guessing that the names listed are the Principal Investigators (individual responsible for the conduct of the trail) for the different pharmaceutical trials and not the entity which receives the checks. In my case, I participate in Phase II and Phase III trials which are required for new drug development. Your article should differentiate the amount of money received for consulting, for speaking fees, and for conduct of a clinical trial for new drug development. The lumping of all of these categories may give the reader a false impression of physicians just trying to get rich. The Sunshine Law may help to differentiate these categories in the future. The public should be aware that the Clinical Trial Industry could be a real economic driver for Indiana since these revenues supports jobs and new job creation. Nationally, this account for 10-20 billion which our State is missing out on to a large degree. Yes, new drug and technology development has gotten most of the attention (e.g. CTSI, BioCrossroads, etc.) However, serious money is being left on the table by not participating in the clinical trials to get those new drugs and medical devices on the market!!!! I guess that this is not sexy enough for academia.
        • To Dr. Toth
          Thanks for reading and replying. If you want to see the differentiation for research, speaking and consulting, check out the spreadsheet I linked to at the bottom of the post; it is broken out exactly that way. I can only include so much detail in a blog post before it becomes something other than a blog post.
        • To JK
          The author is being disingenuous. And is backpedaling. He say in his comment that "...it's important for people to know how much of research and education are funded by pharmaceutical companies." But his text doesn't contain a single use of the word "educate." The article's title - "Doctor's drug money" - is crafted to incite distrust of physicians and industry, and the author clearly states his opinion that "physicians steadfastly deny that their prescribing patterns are influenced by any of this money, but the drug companies obviously believe otherwise--or else they wouldn't keep spending these large amounts." So when the author defends himself by claiming "I'm not saying there is something wrong with it," he is being dishonest. He lists "$1.8 million" next to a researcher's name in an article titled "Doctor's drug money," and then thinks that an intelligent reader will not see the smear? Especially when he then follows that implication with the admission that "[the researcher] may have taken none of it home." It's disappointing to see such biased and lazy commentary (I won't call it journalism) in a reputable paper like IBJ.
          • Bashing continues
            Add this to the list of doctor-bashing articles that JK Wall has become infamous for writing.....
            • To Gojeepdog
              Am I infamous for bashing physicians? I thought it was just the hospitals that thought I had it in for them. If it is "bashing" to point out the money that drives a good amount of the decision-making in health care, then I'll take that title. My goal is to provide a bit of "bashing," so defined, not only to doctors and hospitals, but also to insurers, employers, governments and patients. It seems to me that, of these various players in the health care sector, no one gets upset until their own role in the $2.5 trillion system is in the spotlight.

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