Monday, December 21, 2009

Christmas comes early for 3,700 US doctors on GlaxoSmithKline's payroll

GlaxoSmithKline became the third pharmaceutical giant to start disclosing all the speaking and consulting payments it makes to US doctors, and its list is an eye-popping illustration of the rampant corruption that runs through our current system of medical research. While the majority of the doctors on Glaxo's payroll, which covers a mere three months in the second quarter of 2009, received between $1,000 and $6,000 for speaking gigs, 134 doctors netted payments of $15,000 or more, and a goodly number received very handsome payouts indeed. (In all, GSK paid out a princely sum of $14.6 million to 3,700 doctors in just three months; one can only wonder how much they dispensed for the entire year).

The highest-paid doctor on this list is Dr. Lawrence DuBuske, a clinical instructor in medicine at Harvard Medical School and director of the Immunology Research Institute of New England. DuBuske specializes in allergies and works with medical researchers throughout Eastern Europe on clinical studies of new allergy drugs. He received a whopping $99,375 from GSK in the second quarter of 2009.

For what, you might ask? That's a question better put to DuBuske, but I can tell you that a quick scrutiny of journal articles published this past year reveals that he was the lead author of a review article published in March 2009 in a respected medical journal (Current Allergy and Asthma Reports), which extolled the effectiveness of several drugs for the treatment of allergic rhinitis (the running nose and other bothersome symptoms that occur when you breathe in something you're allergic to).

Surprise, surprise, one of the drugs given an enthusiastic thumb's up in this review is Xyzal, an antihistamine made by GlaxoSmithKline. The other two are drugs made by Schering-Plough (now owned by Merck) and Sanofi-Aventis. And sure enough, DuBuske is not only on Glaxo's speaker bureau; he is also getting speaking bucks from Schering-Plough, Merck and Sanofi-Aventis. Indeed, as the disclosures in his March review indicate, DuBuske is basically on the speaking payroll of every pharmaceutical company that makes or markets allergy drugs in this country.

Gee, I wonder what Harvard Medical School or Brigham & Women's Hospital, where DuBuske is coordinator of the allergy fellowship program and a consultant, have to say about the good doctor's conflicts of interest.

Here's another example of the way Big Pharma has corrupted the way doctors get their information about new drugs: Another well-paid physician on GSK's stocking list this year was Dr. Timothy Beard, a general surgeon and director of research for Bend Memorial Clinic in Bend, Oregon. Beard received $61,380 from GSK in the second quarter of 2009 (and he's not even one of the five highest paid). As a quick Google search reveals, Dr. Beard has done clinical research on a drug called ENTEREG, made by GlaxoSmithKline, and in August 2009, he gave a presentation to the annual meeting of the Northwest Society of Colon and Rectal surgeons about how well ENTEREG works in aiding the recovery of patients who have had bowel resection surgery. Not a bad day's work for $61,380.

Now, as an unpaid blogger, I only had time to connect a few dots, but I have a feeling there is much more to be gleaned from the treasure trove of doctor payments that Glaxo and other drug companies are now disclosing (in anticipation that Congress, as part of health reform, will pass the Physician Payment Sunshine Act and require such disclosures in the future). So I hope that some of the journalists who get paid to do this will take a closer look at more of the happy beneficiaries of the pharmaceutical industry's largesse.

In the meantime, take a minute and check to see if your doctor is on Glaxo's Christmas list. Ho ho ho.

Hat tip to Pharmalot for alerting me to the GSK list.


Anonymous said...

Sigh.... Although forcing these disclosures is actually good news for consumers and patients (we like to know who's paying off our docs to push the drugs we've been prescribed), that GSK list is truly impressive.

What's really interesting to me is the discrepancy that's been noted by the New England Journal of Medicine, who asked orthopedic surgeons speaking at a major conference last spring to disclose if any had accepted cash from drug or device manufacturers - and then compared those numbers with the lists of docs who had actually accepted cash, a list now available from the drug/device companies.

Well, well, well! Results are illumininating - more at "Is Your Surgeon Able To Follow Simple Instructions?" at

Love your blog.

Carolyn Thomas
The Ethical Nag: Marketing Ethics For The Easily Swayed

Michael Kirsch, M.D. said...

Alison, of course the drug companies and some of their physician reps aren't lily white. I am sure that their aggressive sales techniques and 'honoraria' are typical of many industries. Is this practice much different than what occurs every day with our legislators in Washington, D.C? I don't think that a physician receiving compensation from a drug company is tantamount to corruption, but I agree that there should be transparency and disclosure. Let's not go too far, however, just to appeal to public populism. We need cooperation between drug companies and practicing physcians, and payments may be reasonable. In addition, many journal articles ar written by physicians and scientists with a variety of conflicts. If an author must be conflict-free, then we may not have enough experts to publish these papers.

Dan said...

As a drug rep with other big pharma companies, I as a simple sales representative was coerced to spend about 50 thousand dollars a year directly to health care providers.

We were forced to pay doctors in order to maintain our vocations as drug reps.

This practice potentially clouds the judgement of prescribers, and is largely a waste of money on many occasions when a speaker is hired in such a way.

We as drug reps. would pay a speaker, such as a specialist physician, 1500 dollars for a brief presentation, often.

I'm no longer a drug rep for reasons such as this.

Unknown said...

I also got this tip from Pharmalot. I culled the data and did tweeted on how much docs in the Research Triangle area got from GSK (hq'd here). The data were eye-popping... and I reported totals (e.g. Glaxo lists fees pd to docs for 2Q'09 12 Chapel Hill docs got ~57K total in that time. Chk to see if your doc is there!)

I didn't hear from any listeners or Twitter followers though. Now, truth be told, I don't hear from them much. But it DOES make me wonder... do people cynically hear this and shrug their shoulders and think, "Business as usual..."?

Rose Hoban, RN, MPH
Health Reporter - North Carolina Public Radio

(I just got wind of your blog via Gary Schwitzer... I'll be bookmarking you.)


My husband's death is the result of off label promotion and physician payouts for prescribing Wellbutrin or Bupropion for smoking cessation. If you can help me connect the dots....I only have until Feb 2012.

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