At least three dozen doctors in Illinois received payments and perks exceeding $100,000 from drug companies between 2009 and early 2011, according to an updated database that now includes information from a dozen pharmaceutical firms.
Doctors in the state received about $25 million in all from the companies for travel, meals, research, consulting and speaking engagements, the data show. Nationally, the eight companies who provided a full year's worth of payment information doled out more than $220 million in 2010 to promotional speakers for their products.
The data provide a preview of what the public can expect to see in 2013, when all drug and medical-device companies — potentially hundreds — must report such figures to the federal government. As more information becomes available, a more complete picture is emerging of the perks and payments made to physicians.
The most controversial payments involve consulting arrangements and promotional speeches. Drug company officials say they are funding talks that provide much-needed medical education, led by physicians who are experts in their fields. Critics say financial relationships between doctors and drug companies can threaten patient care by influencing physicians to prescribe certain medications whether or not they are the best choice.
Some hospitals are tightening their rules to minimize possible conflicts of interest.
Among the Illinois physicians who received payments of more than $100,000 were a half-dozen physicians at Rush University Medical Center in Chicago. But Rush officials said a policy that goes into effect this month is expected to put a big dent in such payments.
The policy, which broadens existing rules, requires doctors to report all payments from drug companies annually and restricts them from participating in drug company speaker's bureaus, among other things. Physician disclosures are reviewed by a conflicts of interest committee.
"The idea here is we're always dealing with potential conflicts and what we wanted as an organization is to have a mechanism by which they are being managed," said Dr. David Ansell, chief medical officer at Rush.
Dr. John Zajecka, an associate professor of psychiatry at Rush, said he has already cut back on speaking events sponsored by drug companies because of the new policy. He received more than $222,000 from three companies between first-quarter 2009 and first-quarter 2011, most of it for speaking and travel.
"I might do medical consulting in compliance with Rush guidelines, but it will not be promotional," he said.
Until 2009, pharmaceutical company payments to health professionals were closely held trade secrets. But several companies began reporting the information publicly under pressure from lawmakers or as a condition of settling federal whistle-blower lawsuits.
ProPublica published a database called Dollars for Docs in October 2010 that included information from those companies, and it recently updated the database to include 12 companies in all. Eight provided data for all of 2010: Eli Lilly and Co., GlaxoSmithKline, Pfizer, Merck, Cephalon, Johnson & Johnson, ViiV Healthcare and AstraZeneca.
In addition to the payments made to speakers, some companies also disclosed how much they spent on consulting, travel, meals and research.
The payments to doctors and other health care providers in ProPublica's database total more than $760 million and cover reports from drug companies between 2009 and the second quarter of 2011.
The new data offer a glimpse of how the firms have adapted their strategies over time, both to changes in the marketplace and to increased scrutiny of their sales techniques. Many experts predict physicians will back away from working for the companies once their names and pay are publicly revealed.
While some relationships are appropriate — a company funding a doctor's research of new treatments, for example — payments for some activities can undermine trust in the medical profession, said Josephine Johnston, a research scholar at the Hastings Center, a bioethics research institute.
"They make it look like physicians are not impartial or are in the service of the drug companies, and can cause patients to wonder if physicians' recommendations for treatment are being made because it was the best option based on their clinical expertise or because they have a relationship with the company," Johnston said. "I don't think many physicians have taken that risk (of patient distrust) as seriously as they should."
Some doctors urged caution in the way the data are interpreted.