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"The
most glaring example," he says, "comes from Dr. Wilens
disclosures."
Grassley posted slightly more than a third of Wilens' payments ($612,303 out of a total of $1.6 million). Only $69,915 of this (11%) came directly from drug companies. Most of the money ($542,388) came from various third party companies, many, possibly all of which, are CME companies, Carlat reports.
"The biggest tool the industry has for off-label promotion is continuing education," says Adriane Fugh-Berman, an associate professor at Georgetown University Medical Center, involved with a program called PharmedOut, created to educate doctors about the prescribing influences of big drug companies, in the Star-Ledger on June 6, 2010.
"Physicians have freedom of speech and aren't under the same constraints as industry employees," she explained.
When drugs are prescribed for off-label or unnecessary uses, public health care programs not only have to pay for the drugs, they must also pay the prescribing doctors' fees and the cost of medical care for any injuries caused by the drugs.
Government spending tied to psychiatric drugs has gone through the roof in the past two decades due to the bilking of public programs. And no doubt as a result, pharma CEOs are earning over the top pay packages. In 2008, the head of J&J pulled in $29.1 million, Abbott Labs' CEO took home $28.3 million, the top dog at Bristol-Myers earned over $23 million, Lilly's CEO pulled down close to $13 million, Pfizer's took home over $15.5 million, Wyeth's CEO earned nearly $26 million, and Forest Labs' top official was paid more than $6.5 million, according to the AFL-CIO's "Executive Pay Watch" website.
American Psychiatric Association
Early on in his investigation, Grassley asked the "American Psychiatric Association," for an accounting of money received from drug companies and foundations created by drug companies. In 2006, the industry accounted for about 30% of the Association's $62.5 million in financing, or about $18.75 million, according to the New York Times.
The 38,000 member APA describes itself as "a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses."
The outgoing president of the APA is Alan Schatzberg, the same guy whose name appears on the Grassley list.
The "American Psychiatric Foundation," is the charitable and public educational arm of the APA, according to its website. In 2009, the Foundation's 15 member board of directors included four Vice Presidents from the drug companies Pfizer, Eli Lilly, and J&J's Janssen Pharmaceutica division.
On its website, the Foundation identifies drug companies that donate but does not give the exact amount. For example, AstraZeneca, Bristol-Myers, Lilly, Forest, Janssen, and Wyeth are listed as giving "$40,000 and above." However, the few grant reports publicly available show drug companies may be giving more than ten times that amount. Lilly donated $450,000 to the Foundation in 2007, in addition to the $400,000 given to the American Psychiatric Association.
The Foundation also received one grant from Lilly for $241,915 in 2009, and another $20,000 donation to fund the Foundation's Newsletter. The Foundation received $102,961 from Pfizer, and $205,400 from Wyeth, in 2009, as well.
In the first quarter of 2010, the Foundation received grants from Lilly of $36,000, $10,000 and $18,000. Pfizer gave the Foundation $20,000 in the first quarter of 2010.
Pfizer's 2008 grant report shows donations of more than $700,000 to the American Psychiatric Association. Lilly gave the APA grants totaling more than $600,000 in both the first and second quarter of 2008. Wyeth donated $43,831 in 2008.
Lilly's 2009 report shows the APA received four grants of $154,575, $142,575, $142,575, and $154,575. Pfizer gave the group $250,000 in 2009.
