How Big Pharma Might Be Paying Your Doctor's Way

Drug companies foot much of the bill for this country's medical research. Now researchers are being forced to disclose the payments.

Several doctors affiliated with university medical centers in California received compensation from pharmaceutical giant Pfizer Inc. in the last six months of 2009 for research, consulting, speaking engagements and other expenses, according to a list disclosed by the company earlier this month.

Academic medical centers also received hundreds of thousands of dollars for clinical trials during the same period. The University of California regents alone got more than half a million dollars in compensation from Pfizer in the six-month span.

Pfizer disclosed the payments on its Web site as part of an agreement to settle a federal investigation into the illegal promotion of drugs for off-label uses, the New York Times reported.

The company joins Eli Lilly and other companies that have disclosed payments to doctors in recent months. The practice will soon be mandated for all drug- and medical-device companies as part of the new health care legislation. Companies will have to report gifts, entertainment, food, research money and other fees and grants under the new law.

The pharmaceutical- and medical-device industries foot much of the bill for this country's medical research. Researchers are supposed to disclose industry payments and relationships to journals that publish their findings, as well as to their university employers and federal grantmakers.

In recent years, Sen. Chuck Grassley, R-Iowa, found millions of dollars in unreported fees paid to researchers by drug companies. Grassley's inquiry pushed universities and the National Institutes of Health to take a hard look at their conflict-of-interest policies, according to the Associated Press.

Pfizer's disclosures include payments to hundreds of California doctors, including several university researchers. Pfizer also released information about clinical trials the company supports at academic medical centers.

A couple of payments raised questions about compliance with university guidelines on industry relationships. Benjamin Ansell, associate professor at the David Geffen School of Medicine at UCLA, received $1,787 in meals and travel from Pfizer during the six-month period, even though UCLA's Guidelines on Industry Activities state that "Faculty, staff, and trainees are strongly encouraged not to accept such meals at any location under any circumstances."

"There are circumstances under University policy and UCLA guidelines where the provision of or reimbursement for meals by vendors is acceptable," university spokeswoman Roxanne Moster said in a written statement.

Ansell said through a spokeswoman he was not reimbursed for meals but rather received dinners provided to him as the speaker at Pfizer-sponsored events. He was also reimbursed for mileage and parking expenses he incurred when he led these lectures.

The university received $29,000 for lectures led by Ansell. He never received payments for research from Pfizer or any other company, Moster said.

At Stanford University, most researchers with payments from Pfizer disclosed the relationship on their Web site profiles. The Stanford School of Medicine requires that all faculty disclose any personal financial interest with a for-profit company that is related to their research.

The profile for Rona Hu, a clinical associate professor, however, did not include her Pfizer connection until after California Watch asked about it this week. Hu got $34,772 in the last six months of 2009 for educational consulting. A spokeswoman said Hu had planned to report her 2009 payments on the medical school Web site by the school's April 30 deadline. Hu's profile is now updated.

In all, during the last six months of 2009, Pfizer paid about $20 million to 4,500 doctors and other medical professionals, along with payments of $15.3 million to 250 academic medical centers and other research groups for clinical trials, the New York Times reported.

Here are more details of payments in California. Several university officials said they could only provide limited information about the clinical trials on Pfizer's site because the company's payment figures  which only reflect a six-month period -- don't match grant amounts, and the disclosure Web site doesn't post names of investigators or subject areas.

• At UC Davis, professor Cameron Carter was reimbursed for $1,046 in travel and meal expenses as a member of an expert opinion panel in September 2009. The meeting included opinion leaders from other universities and a translational-medicine research team from Pfizer. The meeting was about how modern imaging methodologies could inform the treatment development process, a spokeswoman said.

Pfizer also paid UC Davis $53,153 for clinical trials.

• At Stanford, Pfizer awarded assistant professor Niaz Banaei $56,360 to support the study of the accuracy of histopathology for diagnosis of fungal infections. The company's first payment was $11,272, which is what Pfizer reported on its site. Professor John Schroeder received $38,424 for a range of educational consulting activities for the company.

The university also received $89,540 for Pfizer-sponsored research.

UCLA got $323,122 for clinical trials. The university also got $2,188 for professional advising provided by professor Stanley Korenman, who participated in a one-time consultation relating to one of Pfizer’s studies because of his expertise in research ethics. Korenman said through a spokeswoman he received a consultation payment along with a small check to cover his automotive transportation and toll costs.

UC Irvine received $56,710 from Pfizer for clinical trials. A little less than half of the Pfizer funding went to investigational drug studies at the university's Chao Family Comprehensive Cancer Center, according to university spokesman John Murray. He said the balance appears to have funded studies or trials in the UC Irvine School of Medicine, and in the departments of psychiatry and human behavior, ophthalmology, dermatology, anesthesiology and perioperative care, and medicine and pediatrics.

UC San Francisco got $174,631 for Pfizer-sponsored research, along with $38,500 for professional advising by UC Davis professor David Gandara and UCSF professor John Kane. In addition, Kane received $1,048 from Pfizer for advising, meals and travel.

Kane is a member of an advisory panel for Pfizer, providing information on pathways involved in certain diseases so that the pharmaceutical company can decide which directions they might want to pursue, in terms of drugs, according to a university spokeswoman. Kane performs basic research into the molecular species of high-density lipoproteins that are involved in heart disease.

Investigative reporter Erica Perez covers the higher education beat for California Watch.
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