State doctors receive millions from pharmaceutical firms
BY SHANNON MUCHMORE World Staff Writer
Monday, October 24, 2011
10/24/11 at 7:57 AM
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A University of Oklahoma employee, a part-timer at the Tulsa City-County Health Department and a psychiatrist with the Veterans Administration are among doctors in Tulsa County who have accepted payments, meals or educational items from pharmaceutical companies in the past three years, according to a database published by a nonprofit organization.
Oklahoma doctors received more than $6.3 million from 12 pharmaceutical companies between 2009 and the second quarter of 2011, although not all companies reported for all quarters.
Doctors in Tulsa County received nearly $1.6 million during that time. The three employees at public institutions were among those receiving the most money.
The data were provided by the pharmaceutical companies and culled by ProPublica, a nonprofit investigative journalism organization that has made the data public on its website, available at tulsaworld.com/dollarsfordocs
Beginning in 2013, pharmaceutical and medical device companies will be required to disclose the data.
Paid for speaking
Dr. Damian Laber, director of the Cancer Center at the OU School of Community Medicine in Tulsa, made $27,800 in speaking fees from Novartis in the fourth quarter of last year. Some of that was while employed at OU. He began his job there in August 2010.
A spokeswoman for the university said Laber was not aware of the policy that bans School of Community Medicine employees from giving speeches that promote a pharmaceutical company's products.
He will stop giving such speeches, the spokeswoman said. Laber declined a request for an interview.
Five other employees at the OU School of Community Medicine received meals or educational items worth about $100 or less. Most said they couldn't remember the meal. Such meals are only allowed if they are in conjunction with educational activities, according to the school's policies.
The university could not confirm if that was the case with the meals documented.
One part-time employee received more than $400 worth of meals and another received $625 for consulting.
Dr. James Seebass, a part-time employee at the Tulsa Health Department, made $287,085 between the second quarter of 2009 and the first quarter of this year. The payments from GlaxoSmithKline and Pfizer ranged from $90 for meals to $127,800 for speaking fees.
Melanie Christian, marketing director for the Health Department, said Seebass' job is to read tuberculosis X-rays. He has no input on what medications the department distributes. Those come from the state, she said.
"He's not making purchasing decisions," she said.
Full-time employees for the department must fill out conflict-of-interest disclosure forms for any outside employment, and it must be approved by a supervisor. Part-time employees do not have this requirement, she said.
Seebass, a pulmonologist, did not respond to requests for an interview.
Dr. John Chelf, a psychiatrist with the Jack C. Montgomery VA Medical Center in Muskogee, made $131,087 from Eli Lilly and Pfizer over two years for speaking, travel and meals.
Nita McClellan, spokeswoman for the hospital, said Chelf's engagements are legal as long as he does not speak on behalf of the VA and is speaking only on his own time.
"We don't promote or support the drugs he speaks about," she said.
Through a spokeswoman, Chelf also declined interview requests.
The company paying the most to Oklahoma doctors is Eli Lilly, which is best known for the drugs Prozac, Cialis and Cymbalta. It paid for meals, speaking fees and consultations in amounts ranging from a few dollars to nearly $75,000.
Next is GlaxoSmithKline, which doesn't disclose meal payments. It paid more than $1.3 million to Oklahoma health-care providers for speaking fees. Its most popular drugs are Advair, Flovent and Valtrex.
The largest drug company in the country, Pfizer, which produces Lipitor, Viagra and Celebrex, spent about the same amount in Oklahoma as GlaxoSmithKline but spent the most throughout the country at nearly $260 million.
Among Tulsa County doctors, Sebass received the most from the disclosing companies, followed by Chelf.
Third was Jimmie McAdams, who received $71,233 from four companies for speaking, travel, meals and expert-led forums. He is a psychiatrist at Laureate Psychiatric Clinic and Hospital.
McAdams did not respond to numerous calls requesting comment.
The OU School of Community Medicine's vendor interaction policy states that employees shall not accept gifts or serve as promotional speakers for a company's products or services.
It also states that meals will not be accepted except in conjunction with educational activities. Consultant fees may be accepted, according to the policy.
Gerard Clancy, president of the school, said the policy is taken seriously and bans any promotional activity in patient areas. The policy has been in place since 2004.
One day as the policy was being implemented, Clancy went around throwing out pens, calendars and anything else with a drug company logo on it.
"I just said, 'We don't need that,' " he said.
As a teaching institution, it's important for the school and its employees to set good examples in transparency and interaction with pharmacies, he said.
At the same time, some interaction is necessary. Education and research activities can be important to keep doctors up to date on the latest medicine and devices that may save patient lives, Clancy said.
"That's all through industry relations," he said. "You can't throw out the whole thing."
The Oklahoma State University Center for Health Sciences had more than 30 employees who received something from a drug company in the time period examined.
They ranged from adjuncts who may have taught only one class, to full-time employees of the center. Dollar amounts start at $12 for a meal and go to $42,450 for speaking.
The Center for Health Sciences is governed by the overall OSU conflict of interest regulations, which state all employees must make an annual disclosure of any significant financial interests that would reasonably appear to be a conflict of interest.
It does not specifically mention pharmaceutical companies or receiving meals from vendors.
Some of the people on the list work with OSU for a few hours a semester as a guest lecturer, said Mary Bea Drummond, a spokeswoman with the university.
"These are private practice people," she said. "They have their own office and everything. And they sometimes do something for the school."
Most hospitals in Tulsa have vague or not fully-formed policies regarding drug company payments.
Officials with Hillcrest Medical Center and St. Francis Hospital said policies are being developed. St. John Medical Center officials said the hospital follows Joint Commission standards that require disclosure of any conflict of interest relating to patient care.
None of the doctors receiving the most money in Tulsa County returned phone calls seeking comment and most denied interview requests.
William Yarborough, vice president of medicine at OU-Tulsa, said industry relations have changed dramatically in the 30 years he's been practicing medicine.
Toward the beginning of his career, Yarborough, like many doctors, was paid by pharmaceutical companies to give speeches about their products. He has stopped these speaking engagements because times have changed, he said.
"I was certainly never influenced by the drug companies to say a certain thing," he said.
Still, there may be some subtle influences when an outside corporate interest is involved. Continuing education seminars are often sponsored by drug companies but contain important and necessary information for doctors. Sometimes the conferences will include meals that are paid for by drug companies, and it can be difficult to tell who is behind some of them, Yarborough said.
"They don't give away the trinkets they used to or the ink pens, but they're still there," he said.
Yarborough is listed in the database as accepting $25 for educational items. He said he didn't know what the money would be for but could be related to a book he was sent through the mail.
He said he is fine with the financial ties between doctors and drug companies being made public but worries that it may be misinterpreted or misunderstood.
"People don't know sometimes what they're looking at," he said.
Original Print Headline: Doctors get drug firm money
Shannon Muchmore 918-581-8378