Cash-to-Doctors Data Reflect Rivalries

Source: Financial Times

Doctors specializing in diseases of the central nervous system and mental disorders receive more money from the pharmaceutical industry than their counterparts in other branches of medicine, according to an analysis of U.S. data.

Research by ta-Scan, a consultancy that operates a database of payments by drug companies to doctors, shows that of $1.2bn in disclosed payments since 2009, nearly a quarter went to two specialties which have among the largest number of competing drugs — but for which the science and efficacy is often debated.

A total of $152m went to those specializing in diseases of the central nervous system including epilepsy and Alzheimer’s, and a further $117m to those treating mental disorders such as schizophrenia, depression and psychosis.

That contrasts with $130m for oncology and $125m for hematology, the other leading therapy areas.

The figures partly reflect intense rivalry between drug companies selling treatments for the two categories, which are aggressively marketed in the U.S. via sales forces targeting large numbers of doctors working in primary care. The payments cover areas such as consulting, entertainment and research.

Among leading medical and clinical researchers, those specializing in mental disorders also received more on average per person from drug companies than any other therapeutic category at $14,176 each.

That contrasted with $12,643 for experts in pulmonary disease and $11,575 for those working on diseases of the central nervous system.

David Cocker, the head of MDC Partners, which owns ta-Scan, said: “Psychiatric drugs are difficult to measure with pure laboratory end points, so eminent opinions have more impact on prescribing behaviour.”

He drew a contrast with lower average payments to leading specialists in diseases that were easier to measure with laboratory tests and often involved the use of higher-priced therapies, including cancer.

The research comes as the American Psychiatric Association this week releases the fifth edition of DSM, its diagnostic manual, which has further expanded the range of conditions covered, opening the prospect of still broader prescription of drugs in the U.S.

The new version of the manual has sparked fierce debate, with critics arguing that it will unnecessarily boost the use of medicines.

Daniel Carlat, a psychiatrist who runs the Prescription Project at The Pew Charitable Trusts in the U.S., said: “We want our physicians to make their medication choices based on the medical evidence and not influenced by a payment from a drug company.”

(c) 2013 The Financial Times Limited