Characteristics of physicians receiving large payments from pharmaceutical companies and the accuracy of their disclosures in publications: an observational study

Abstract

Background: Financial relationships between physicians and industry are extensive and public reporting of industry payments to physicians is now occurring. Our objectives were to describe physician recipients of large total payments from these seven companies, and to examine discrepancies between these payments and conflict of interest (COI) disclosures in authors' concurrent publications.

Methods: The investigative journalism organization, ProPublica, compiled the Dollars for Docs database of payments to individuals from publically available data from seven US pharmaceutical companies during the period 2009 to 2010. We examined the cohort of 373 physicians in this database who each received USD $100,000 or more in the reporting period 2009 to 2010.

Results: These physicians received a total of $52,600,624 during this period (mean payment per physician $141,020). The predominant specialties were internal medicine and psychiatry. 147 of these physicians authored a total of 134 publications in the first quarter of 2011 and 77% (103) of these publications provided a COI disclosure. 69% of the 103 publications did not contain disclosures of the payment listed in the Dollars for Docs database.

Conclusions: With increased public reporting of industry payments to physicians, it is apparent that large sums are being paid for services such as consulting and peer education. In over two-thirds of publications where COI disclosures were provided, the disclosures by physician authors did not include industry payments that were documented in the Dollars for Docs database.

Figure 1

Study flow diagram. See text for details. Authors refer to individuals for whom we identified a publication within the period January to March 31, 2011.

Figure 2

The relationship between disclosures in publications and known payments by pharmaceutical companies to physician authors. Abbreviations: AZ, AstraZeneca; GSK, GlaxoSmithKline; J&J, Johnson & Johnson. Both the grey and black bars represent discrepancies between the Dollars for Docs database and the physician author’s disclosures in publications. Dollars for Docs payment disclosed means that the specific company that made a payment to the physician was listed in the author’s disclosures in the publication. Discrepancy in the conflict disclosed means that one or more financial conflicts of interest were disclosed in the publication, but not the payer reported in the Dollars for Docs database. No conflicts of interest disclosed means that the publication stated that there were no conflicts of interest despite the Dollars for Docs database listing a payment.