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  • 4

    Pfizer Gives Details on Payments to Doctors

    By DUFF WILSON

    Published: March 31, 2010

    Pfizer, the worlds largest drug maker, that it paid

    about $20 million to 4,500 doctors and other medical professionals for

    consulting and speaking on its behalf in the last six months of 2009, its first public accounting of payments to the people who decide which drugs to recommend.

    Pfizer also paid $15.3 million to 250 academic medical centers and other research groups for clinical trials in the same period.

    While other pharmaceutical companies have disclosed payments to doctors, Pfizer is the first to disclose payments for the clinical trials. The disclosure does not include payments outside the United States.

    A spokeswoman for Pfizer, Kristen E. Neese, said most of the disclosures were required

    by an integrity agreement that the company signed in August to settle a federal investigation into the illegal promotion of drugs for off-label uses.

    Dr. Freda C. Lewis-Hall, Pfizers chief medical officer, characterized the disclosure and Web site as part of a march to disclosure that the company started in 2002.

    Pfizer is the fourth major drug company to make such disclosures, following Eli Lilly, Merck and GlaxoSmithKline. All four Web sites are searchable by the names of doctors or organizations, but all are set up in ways that make it difficult to download and analyze the entire database.

    All of them are welcome, but none of them is a replacement for a single national database, said Allan Coukell, director of the Pew Prescription Project, an initiative of the Pew Charitable Trust.

    Beginning in 2012, drug and medical device companies will

    be required to disclose payments to doctors of more than $10, with the first report available in 2013. The Physician Payment Sunshine Act was passed as

    part of health care reform. Some states also have disclosure laws.

    Ms. Neese said the disclosures included elements not required by the federal agreement, like payments to academic centers and to nurse practitioners and physician assistants.

    The reporting also goes beyond the Sunshine law, Pfizer said, by not imposing a delay of up to four years on financial support for clinical trials. Pfizer plans to report the payments without the delay.

    Dr. Marcia Angell, former editor of The New England Journal of Medicine and a writer on conflicts of interest, said, If theyre doing that it would amaze me if they did, but if they are thats great.

    Dr. Angell said the Pfizer amounts seemed low although she had no specific knowledge. I cant help but think something has escaped, she said.

    Pfizers disclosure met with skepticism from one specialist on conflicts of interest in medicine.

    I think its a good thing to do, but I put absolutely no trust in what drug companies voluntarily disclose to the public when those things are unaudited,

    said Eric G. Campbell, lead author of a 2007 study of physician-industry relationships published in The New England Journal of Medicine.

    Professor Campbell, who is director of research at the Mongan Institute for Health Policy at Massachusetts General Hospital and an associate professor at Harvard Medical School, said drug companies were trying to get ahead of a rising tide of public opinion for disclosure.

    The payments to doctors covered fees, travel and meals worth $25 or more and totaling $500 or more during the six-month period, Pfizer said.

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    Fortune: You spent most of your career as a heart surgeon. In business terms, you were a technician, a producer. Then you were made CEO. When that kind of move happens in business, it doesn't always work out. What did you learn that

    helped you make the transition successfully? Delos Cosgrove: I went to school when I realized I was going to have this opportunity. I studied. I would work a day, and then I'd go home and hit the books at night. I had a lot of people who were very generous with their advice. They didn't sit down and draw it out on a blackboard, but they gave me little pieces of information, and they were kind and supportive in tough times -- everybody from [Harvard business professor] Michael Porter to [GE CEO] Jeff Immelt and [former GE chief] Jack Welch and [Boeing CEO] Jim McNerney. They were very generous with their time and their suggestions, and I'm grateful for that. , - , - !.

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