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Registry of drug firm payments

Senator Grassley wants registry of drug firm payments to doctors.

Senator Charles Grassley (R-IA) plans to introduce legislation requiring drug makers to disclose the payments they make to doctors for services such as "consulting, lectures and attendance at seminars," according to An August 3, 2007 report in the New York Times. In support of his proposed bill, Sen. Grassley cited the case of a child psychiatrist who was paid $180,000 by the manufacturer of an antipsychotic drug that is now widely prescribed to children.

Drug manufacturers make millions of dollars in payments to physicians who later prescribe the manufacturer's drugs to their patients. These payments may take the form of "consulting fees" or lecture fees. The "lectures" are often given at fancy resorts. In addition, many published studies on the efficacy of medications are authored by doctors who have taken such payments from the manufacturer involved int eh study.

Many published reports by doctors are later cited by the drug companies' sales representatives as support for the "off-label use" of their drugs. A medication's use is "off-label" when it is used for any purpose other than the uses for which it was approved by the FDA. Although it is legal for a physician to prescribe a medication for "off-label use," it is not legal to bill Medicare or Medicaid for such use.

Some university now require their researchers to disclose these potential conflicts of interest, but, according to Grassley, oversight of the disclosures is often lacking. Moreover, many universities that do require disclosure of drug company payments do not make the information available to patients, who are unaware that their physician's objectivity may be affected by money received from the manufacturers.

The child psychiatrist cited by Sen. Grassley, Dr. Melissa DelBello of the University of Cincinnati, published studies on the anti-psychotic drug Seroquel, manufactured by AstraZeneca. Although her studies were reportedly inconclusive, she has described the studies as showing that Seroquel could be of benefit in some children. Seroquel is now widely prescribed. When asked how much money she had received from AstraZeneca, Dr. DelBello was quoted by the Times as saying, "Trust me, I don't make very much." However, disclosure forms filed by Dr. DelBello with the University revealed that she $180,000 in 2003-04, calling onto question Dr. DelBello's definition of "not much." She also "consults" for seven other drug manufacturers besides AstraZeneca.

Minnesota, Maine and Vermont are the only states that presently require licensed physicians to disclose payments from drug companies.

Keith CrossJoe Bennett
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