Imagine that you are a Type 1 diabetic, meaning your pancreas has never produced insulin. Beyond taking regular insulin injections, there isn’t much in the way of treatment available – but your doctor wants to put you on a medication for Type 2 diabetes, which is a completely different disease. It may be something like Actos, or Invokana, neither of which are indicated for Type 1. Alternatively, your doctor may be trying to convince you to take something “off-label,” meaning the medication in question is being prescribed to treat something for which it is not approved (for example, prescribing Celebrex – an anti-inflammatory used by arthritis patients – for treating non-cancerous tumors). Is it possible that your doctor has been given a financial incentive by the drug maker to prescribe such medications?
While this is not necessarily the case (a licensed physician may legally prescribe any drug for off-label use if, in his or her professional opinion, it will benefit the patient), there is a way to find out. A government website, known as Open Payments, enables anyone to enter the name of their physician and quickly find out if they have been paid or received other compensation by a drug company, the identity of the drug company, and how much. It is also possible to search drug makers by name in order to learn how much they have paid out to physicians (you’ll need to know where the company’s headquarters is located).
These days, considering the behavior of Big Pharma, it’s easy to assume that these payments represent bribes and kickbacks. While this certainly does happen, it should be kept in mind that this is not necessarily the case. In most cases, these amounts simply represent the cost of doing business. Most of the time, it involves sending sales representatives out to meet with physicians over lunch. Drug companies also frequently hire physicians for consulting purposes in order to get information about how the drug is working under “real world” conditions, or to get medical recommendations from a professional who is actually treating patients.
It should also be kept in mind that there are (for now) laws in place, making it illegal for drug companies to give “gifts of substantial value.” While some pharmaceutical companies manage to skirt the law in this respect, it is actually rare for a drug maker to get away with it. The Open Payments website, maintained by the Department of Health and Human Services, exists primarily for the sake of transparency. If you are a patient and have reason to suspect that your doctor is receiving financial incentives to prescribe a particular medication, the best course of action is to research the matter further and discuss your concerns with your health care provider.