Doctors: Drug presentations are balanced

Dr. James Loos turned on his laptop and opened a PowerPoint presentation given to him by GlaxoSmithKline to share with other doctors.

A series of slides discussed the risks and benefits of Jalyn, a drug that combines two popular medicines into one for the treatment of enlarged prostate.

Since 2009, Loos has accepted $11,313 to speak about GlaxoSmithKline drugs, according to a nationwide ProPublica database of physicians receiving payments from drug companies.

The database created by the nonprofit investigative organization offers details on $761.3 million in payments made nationwide by 12 drug companies from 2009 into this year.

Locally, Rogue Valley doctors received almost $400,000 for speaking, research, consulting, travel and meals, the database shows.

Loos agreed to share the contents of a typical slide presentation created by the drug company.

A urologist with Medford-based Urology Associates of Southern Oregon, Loos said he earns about $750 to $1,000 to familiarize himself with slides and then do a one-hour presentation to other doctors.

Usually a handful of physicians — fewer than 10 — attends the presentations, Loos said.

Sometimes the doctors can't all meet at once so he visits them one by one, but still makes the single fee, he said.

Loos said he hasn't felt any pressure from GlaxoSmithKline to prescribe more of the company's drugs since he began speaking about them.

"What I could see happening is you have to research it. By being more knowledgeable, you could prescribe it more," Loos said. "The idea of the talks is to get the audience to prescribe it."

He said while that may be the drug company's intention, the slide shows may have the opposite effect.

"If you hear one of the talks, it almost talks you out of using the medication. There are all of the negative things that could happen," Loos said. "It's kind of surprising."

The Jalyn slide show warned that the drug could increase the risk of high-grade prostate cancer. Side effects can include ejaculation disorders, impotence, decreased libido, breast disorders and dizziness.

Side effects can be worse when men take the Jalyn combination drug, rather than a single medicine to treat symptoms of enlarged prostate, the slide show said.

However, Jalyn can do a better job of alleviating symptoms, it said.

"Here's their cheerleader slide," Loos said, moving on to a slide that said patients saw a 66 percent greater reduction in symptoms after four years on the combination drug compared with one drug alone.

Loos said people sit through the slide show presentations, but he thinks they most often attend so they can take part in question-and-answer periods that follow. Sometimes medical residents come to get a free dinner if the drug company provides meals with a presentation, he said.

Loos said the drug company presentations provide a means for doctors to get together and talk about treatments, something they can have trouble doing on their own.

"It's just not practical. Everyone works 50 to 80 hours a week. You can't do that and have someone just voluntarily work extra hours to do a talk," he said.

Loos said when he first started speaking about drugs three years ago, he was allowed to prepare his own talks. Now the drug companies create the slide presentations to ensure that drug risks and benefits are disclosed, and to keep doctors from discussing uses that haven't been cleared by the federal Food and Drug Administration.

Dr. Kevin Parks, of the Allergy & Asthma Center of Southern Oregon in Medford, said he also gives presentations with drug company-created slides.

Parks has been involved in research on asthma and other conditions.

He accepted $33,325 from AstraZeneca and Merck in 2010 for speaking, according to the ProPublica database.

"I have to use company-approved slides that meet FDA standards for fair and balanced information," Parks said, noting that over the years, he believes drug presentations by doctors have improved and become more balanced.

"Some attendees may even get bored by all the negative information about side effects," Parks said.

While use of the drug company-prepared slide shows is widespread, doctors at Oregon Health & Science University — considered one of the premiere medical institutions in the state — must have input into the presentations they deliver about drugs, said Kara Drolet, associate director of OHSU's Research Integrity Office.

"They shouldn't be handed a presentation they had no input into. That's not an allowable kind of presentation," Drolet said.

OHSU's Dr. George Keepers, who helped develop drug company payment policies for OHSU doctors and researchers, said the speaking events can be useful.

"Some lectures do have a legitimate purpose to convey accurate information about new pharmaceutical agents to the field," Keepers said. "We have expert physicians who are often involved in research. It allows people who are truly expert to interact directly with other physicians."

To see if your doctor is listed in the ProPublica database for taking contributions from drug companies, visit

Vickie Aldous is a reporter for the Ashland Daily Tidings. She can be reached at 541-479-8199 or

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