Physician speaking fees: Information or Sales pitch?

Eli Lilly as well as many other drug manufacturers often pay physicians thousands of dollars as “Faculty” to teach other doctors about a variety of medications in use for their particular field. Although doctors need continuing education, many critics feel that this is simply marketing forums for the drug companies to drive sales for the higher end medications, and to keep the customer base flowing.

Eli Lilly was fined 1.4 billion dollars in January to settle a lawsuit by the federal government that it illegally promoted drugs for “off label” use, or simply pushing medications to be prescribed for uses that are not FDA approved. Pfizer also paid a whopping $2.3 billion in September for the same activity, and as part of the settlements, they must disclose a listing of physician speaking fees that they are paying to promote their medications.

In central Florida, and as part of the disclosure for illegal marketing practices by Lilly, 39 doctors alone out of 3400 nationally were paid over $230,000 in the first quarter of 2009. The speeches are legal, but many believe that they are just sales pitches disguised as seminars to get more revenue for the pharmaceutical companies.

The fees vary, but the average speaking fee is about $1500 plus expenses, but many are paid much more. For example, Dr. Damon Tanton was paid $12,637.50 to talk to doctors about Byetta, a diabetes drug produced by Lilly. In fact, Eli Lilly and Co. paid a total of $22 million this quarter for the 3400 physicians who they describe as the “Lilly Faculty”.

Dr. Tanton, who specializes in diabetes and metabolism, said "The overriding issue is that this is a drug I know lots about, and when I talk about it I start out with an overview of diabetes in general, so I do think it brings in a big educational component ". However, critics like Eric Campbell, a Harvard Medical School professor believe that it is only about making money. Campbell states, "The focus may get away from what is best for the patients."

Dr Tanton has said that he has bee prescribing Byetta long before Lilly approached him to speak about the drug, even though physician speakers as well as pharmaceutical companies say the seminars are educational, and are focused on scientific facts that help primary-care and other physicians learn pros and cons of medications that they may not prescribe on a regular basis.

The bottom line is that almost all pharmaceutical companies pay doctors fees to give speeches about the drugs that they produce. Recently, Schering-Plough offered a variety of psychiatrists around the country up to $1,600 a day and $170,000 total to talk about Saphris, the new psychiatric drug produced by them.

Fees paid to doctors are only one type of potential conflict of interest in health care that has been reviewed by the Institute of Medicine, a research organization that is part of the National Academy of Sciences. A panel within the Institute recommended halting the speaking payments hosted by drug companies, saying that the research shows that the payments lead to increased drug revenues.