Drugmakers Paid $14M to Doctors Treating California Foster Children

Drugmakers have spent millions of dollars to influence the decisions of physicians who prescribe psychiatric medication to children in California's foster care system, according to a recent investigation by the Los Angeles Daily News.

Background

The investigation comes after a separate analysis by the San Jose Mercury News found that psychiatric drugs are being overprescribed to the 60,000 California children in foster care (de Sá, Los Angeles Daily News, 11/22).

The earlier investigation found that nearly 25% of California children in foster care have been prescribed psychiatric drugs. Further, 12.2% of foster children in 2013 who were on one psychiatric medication were prescribed additional psychiatric drugs, compared with 10.1% in 2004 (California Healthline, 8/26).

Details of New Report

The new investigation examined the financial connections between drugmakers and physicians who prescribed psychiatric medication to foster children.

For the investigation, the Daily News examined records from July 2009 to July 2014 obtained from the California Department of Health Care Services.

Physicians were identified by:

• Address;
• Name; and
• Whether they prescribed more than 75 psychotropic medications each fiscal year.

The analysis matched 1,647 prescribing physicians with doctors in a database of drugmakers' payments (Los Angeles Daily News, 11/22). Pharmaceutical companies can make payments to physicians in the form of:

• Gifts;
• Lecture fees;
• Meal and travel reimbursements; and
• Research funding.

Findings

Overall, drugmakers made payments to 908 California physicians between 2010 and 2013, more than half of whom prescribed psychiatric medication to foster children. In that time, pharmaceutical companies paid more than $14 million to California doctors who treat children in the foster system.

Further, the investigation found that such physicians received on average more than double the payments made to other types of physicians in California.

In addition, researchers found that physicians who prescribed more than 75 medications in a fiscal year received about $10,000 more than those who prescribed fewer psychiatric medications.

Reaction

According to the Daily News, physicians who receive gifts, funds or reimbursements from drugmakers say they are not influenced by such payments and maintain that such partnerships are necessary for medical innovation.

John Murphy, assistant general counsel for the Pharmaceutical Research and Manufacturers of America, said, "The kind of medical innovation that we have in this country wouldn't happen without a robust dialogue between industry and physicians."

However, critics of the practice say that drugmakers are disguising gifts as "investments in the name of science" as a way to boost their business.

UCLA professor David Cohen said, "These figures suggest these doctors are not looking out primarily for the kids' interests," adding, "They suggest many doctors are looking out for their financial interests, and we should all be wary" (de Sá, Los Angeles Daily News, 11/22).