Pharmaceutical companies have paid Rogue Valley doctors and researchers at least $396,448 for drug research, meals, travel and consulting, and for speaking to their colleagues about drugs in the past two years.
A new database created by the nonprofit investigative organization ProPublica offers details on $761.3 million in disclosed payments made nationwide by 12 drug companies from 2009 into this year. Nearly $6 million of those payments went to Oregon.
Some of the drug companies agreed to publicly report the payments after shelling out millions of dollars to settle lawsuits claiming they had improperly influenced doctors to prescribe drugs, often for off-label uses that hadn't been approved by the federal Food and Drug Administration.
All drug companies will be required to report payments to doctors in 2013 as part of the health care reform law.
In Jackson County, the Clinical Research Institute of Southern Oregon in Medford brought in the highest figure. GlaxoSmithKline paid the institute $195,833 to conduct research on drugs.
Dr. Edward Kerwin, medical director for the institute and the Allergy & Asthma Center of Southern Oregon, located in the same building, said the payments cover the costs of research studies and pay the salaries of 15 to 20 full-time professional employees.
Kerwin said the money helps support the local economy and brings in outside dollars while advancing medical research.
"Clinical research provides great medical and economic benefits," he said.
The institute's work has helped bring a range of medicines through clinical trials, including drugs to treat asthma, chronic obstructive pulmonary disease, allergies, diabetes, high cholesterol and high blood pressure, he said.
Kerwin said the institute doesn't do Phase I safety studies, so all of the drugs already have been shown to be generally safe for humans. Many have been approved in Europe and Canada, but need U.S. approval.
"Most of the patients in our studies don't have medical insurance," Kerwin said. "Thousands of patients have received free care. We give them treatments, and we are reimbursed by the drug company. The medicines are often state-of-the-art."
Kathryn Schuff, co-chairwoman of Oregon Health & Science University's Institutional Review Board — also known as its ethics committee — said researchers often deal with the dilemma that people without insurance disproportionately try to enroll in studies.
OHSU, based in Portland, doesn't ban uninsured people from studies, but it is careful in advertisements not to promote a study as a way to get free medical care, Schuff said.
"Even people with insurance need to realize that research studies are not a substitute for appropriate medical care. Sometimes our patients have that misconception," she said. "They think they will get better treatment than if they go to a regular doctor. But the whole point of doing a study is we don't know if a new drug will be better."
Dating back to 2009, OHSU received $460,551 in reported payments from drug companies for research, consulting and speaking, with the bulk of the money paid for research, according to the ProPublica database.
Schuff said she believes it is appropriate for drug companies to help pay for research into prospective new medicines.
"The pharmaceutical companies are doing it for a profit to try and get a new treatment approved by the FDA and to be able to market that. We feel the pharmaceutical company needs to help pay for that research," Schuff said.
In addition to getting research dollars for his institute, Kerwin accepted $1,627 for travel from the pharmaceutical company Cephalon, according to the ProPublica database.
Sunstone Medical Research LLC in Medford earned $50,839 from Pfizer for research, while PPD Development LP, also in Medford, brought in $7,242 from GlaxoSmithKline for research, according to the ProPublica database.
Dr. Patrick Gillette received the second-highest amount of payments from drug companies, after Kerwin's Clinical Research Institute of Southern Oregon.
Since 2009, Gillette has accepted $54,725 from Pfizer and AstraZeneca for speaking, according to the ProPublica database.
Gillette was formerly a colleague of Kerwin's at a mood and memory center, but he is now the medical director for Community Health Center, according to Kerwin and health center staff. CHC is a nonprofit corporation that serves low-income, uninsured and Oregon Health Plan clients at clinics in Medford, Ashland and White City.
Gillette did not respond to a request for comment.
He has served as an investigator and consultant on Alzheimer's, asthma and major depression clinical trials, and is the co-author of a handbook on bipolar disorder, according to an online biography.
After Gillette, Dr. Kevin Parks — who works at Kerwin's asthma and allergy center — accepted the highest amount for speaking.
Parks has been involved in research on asthma and other conditions.
Parks received $33,325 for speaking from AstraZeneca and Merck in 2010, according to the ProPublica database.
Parks said he is on a few speakers' bureaus for pharmaceutical companies because of his expertise in treating asthma.
He said companies often ask specialists — referred to as "thought leaders" — to give educational programs to doctors, nurses, pharmacists and nurse-practitioners.
Drug companies prepare slide shows for the paid speakers to present. The slide shows must meet FDA criteria that they be fair and balanced, discussing both the risks and benefits of the drugs, Parks said.
"I'm not allowed to create my own slides," he said.
Parks said the slide-show presentation is followed by an open discussion period, where health care providers without expertise in asthma can talk with him about difficult cases. Often he travels to remote areas such as Coos Bay or Brookings.
Parks said the speaking fees from drug companies help him cover his costs, including paying his office staff while he is away.
He said he doesn't believe he is unduly influenced to prescribe more of a specific drug because of the drug company payments, especially because he speaks for companies that have drugs in competition with each other.
Parks said he has also turned down speaking fees.
"I've declined invitations to be on speakers' bureaus because I did not feel good about the product. If I can't support it, I won't give the talk. It doesn't matter what they're willing to pay me," he said. "I don't want my name and professional standing correlated with a product I don't think is an option for treating asthma."
Parks said he was disturbed to read in national media reports that some drug companies use speakers who are not board-certified in their specialty, or who are facing disciplinary action.
Parks said he would hesitate to work with such a company.
He said he is contractually required to report any disciplinary action to the pharmaceutical companies that pay him.
Parks said his patients have sometimes asked him about his involvement with drug companies, and he is encouraged by their concern and desire to be fully informed. He said he discloses his activities and reviews all treatment options, including generic drugs.
While some patients may be concerned about the influence of drug companies on doctors, Parks said insurance companies and Medicare have a far greater influence because they usually limit coverage to only one or two drugs for a condition.
Kerwin said he used to do speaking for pharmaceutical companies, but now is too busy with his research work.
He said he does attend speaking events to listen to other doctors, and finds the talks to be of great service, with information about the latest and best treatments.
Kerwin said he has some concerns about doctors who earn so much from speaking fees that it could become their livelihood.
"I worry about doctors who make large amounts of money from speaking. Some doctors are almost like a surrogate employee of the drug company," he said. "But the vast majority are giving an educational service."
The Pharmaceutical Research and Manufacturers of America industry group said companies invested $49.4 billion in 2010 to discover and develop new medicines.
PhRMA said once medicines are approved by the FDA, they need to reach the patients who need them, and paying doctors speaking fees helps achieve that goal.
"Federal law and the PhRMA Code clearly prohibit companies from retaining physicians as speakers in order to induce or reward the physicians for prescribing a particular medicine or course of treatment," PhRMA said in a statement.
PhRMA said it supports sunshine laws to make information about payments to doctors public.
ProPublica has encouraged patients to check its searchable database to see whether their doctors are listed.
Until mandatory payment disclosure rules go into effect in 2013, patients also should ask their doctors about drug company payments, since not all payments have been made public, ProPublica said.
If a doctor is receiving money from a company that makes a drug taken by the patient, the patient should ask about alternatives that may be less expensive or have fewer side effects, ProPublica advised.
To search ProPublica's database, see http://projects.propublica.org/docdollars/search?
Reporter Vickie Aldous can be reached at 541-479-8199 or email@example.com.