Carlat: How Drug Companies Hid Millions in Physician Payments in Vermont

3E9EEBDD-4D1B-46DE-A372-8F18911711CD.jpg

This one hits close to home, as I live in Vermont. As Daniel Carlat notes, Vermont is one of the few states to actually require drug companies to disclose drug-company payments to MDs, but the state allowed exception for payments related to 'trade secrets.' The companies apparently made the most of this.

The Carlat Psychiatry Blog: How Drug Companies Hid Millions in Physician Payments in Vermont:

Vermont is one of a handful of states that requires drug companies to disclose their payments to physicians. But the law contains a loophole as big as the Ritz%u2014companies are allowed to withhold information on payments that they consider %u201Ctrade secrets.%u201D

Ever since the Vermont law was passed, many have wondered what on earth these %u201Ctrade secrets%u201D might be. A research letter published in this week%u2019s edition of JAMA (Journal of the American Medical Association) finally provides the answer.

The non-profit group Public Citizen sued to obtain information on the trade secret payments, and here it is. During the two year period from the summer of 2002 to the summer of 2004, drug companies made 21,409 payments, primarily to doctors, totaling $4.90 million. 42.9% of these payments, totaling $2.72 million were labeled %u201Ctrade secrets.%u201D

The researchers, led by Dr. Joseph Ross at Mt. Sinai School of Medicine in New York, focused their analysis on those payments to physicians of more than $100 (the Vermont law requires disclosure of all payments of at least $25). There were 4743 payments that exceeded $100, totaling $3.2 million. 49% of these larger payments were trade secrets. The median trade secret payment was $500 per doctor, far greater than the median non%u2013trade-secret%u2013designated payment of $177.

What kinds of payments were considered trade secrets? One would assume these would be for consulting arrangements in which doctors give advice about secret new products in the pipeline. But %u201Cconsulting%u201D constituted only 8.2% of trade secret payments.

By far the majority of trade secret payments were for promotional speaking (43.2%) and for %u201Ceducational%u201D activities%u2014presumably CME (41.7%). Most such gigs are well-publicized by mailings to doctors' offices, and they are typically for products that are already FDA-approved.

Calling promotional speeches and CME events %u201Ctrade secrets%u201D is Orwellian double-speak at its finest. Luckily, the Physician Payment Sunshine Act, likely to be passed by Congress in the coming year, does away with this loophole.

More like this

One of the less-noticed provisions of the Affordable Care Act is a requirement that pharmaceutical companies report to the Department of Health and Human Services the gifts and other payments they give to doctors and teaching hospitals -- and that HHS in turn make that information available to th
Last week, President Obama signed long-awaited legislation that will put an end to periodic panic at the prospect of massive, sudden cuts to Medicare physician payments.
I've written before about how the housing fiasco required fraud and perjury. Well, there's no end in sight for the damage done by Big Shitpile.
One thing that I've been getting a lot of requests about is the ongoing mortgage mess in the US. I wrote a bit about it a while ago, explaining what was going on. But since then, I've gotten a lot of people asking