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How far can you trust your pharma-rep doc?

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A new investigation shows that doctors drug companies hire as speakers and advisers aren’t always the best and the brightest in their fields. Some of them are outright criminals. .

ProPublica recently created a database of the payments made to doctors by seven major drug companies: AstraZeneca, Cephalon, Eli Lilly & Co., GlaxoSmithKline, Johnson & Johnson,  Merck & Co. and Pfizer. The database includes just under $258 million in payments made since 2009 to doctors, based on disclosures made by the companies themselves. The payments are generally fees for speaking engagements, as well as advisory and consulting work.

ProPublica then did a review of the highest-paid physicians’ licensing records in their states. While not a complete review of the speakers, it did turn up some disturbing information.

According to ProPublica, more than 250 physician-speakers had professional sanctions against them for infractions including having sex with patients, poor patient care and improperly prescribing medication.

More than 40 had official FDA warnings for research misconduct, had lost hospital privileges and/or been convicted of crimes. Another 20 had two or more malpractice judgments or settlements against them. (Note: Some states don’t make this information publicly available, so the actual numbers of speakers who have such blemishes in their records may be higher.)

Who’s vetting the docs?

Five of the companies admitted to ProPublica that they don’t routinely check state board records for doctors they’ve hired or are considering hiring. They check the federal database and count on doctors to self-report additional information. The two companies that do check: Cephalon and Johnson & Johnson.

These doctors aren’t accused of minor paperwork slip-ups — the ethical violations put their objectivity and expertise in real doubt: In one case,  the FDA ordered a doctor to stop his “false or misleading” promotions of a painkiller, citing him for downplaying its risks and encouraging its use for unapproved treatments. Since then, three pharmaceutical companies have paid him at least a quarter of a million dollars to give speeches to other doctors for their medications.

Another doctor was found by the Ohio medical board to have performed unnecessary nerve tests on 20 patients, including injecting them with chemicals that destroyed nerve tissue. He’s been paid $85k in the past two years as a speaker and adviser to drug companies.

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