The U.S. prescribes anti-psychotics to children and adolescents at a rate six times greater than the U.K. which has socialized medicine and charges the same cost for any medicine. In June 2007, The New York Times reported that psychiatrists in Vermont and Minnesota topped the list of doctors receiving pharmaceutical company gifts and that this financial relationship corresponds to the “growing use of atypicals (new anti-psychotics) in children.” From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than six-fold to $1.6 million. During these same years, prescriptions of antipsychotics for children under the state’s insurance program rose more than nine-fold.
Doctors and hospitals having financial relationships with health care manufacturing companies stimulated the creation of Open Payments, a federally run transparency program begun in 2014 that collects information about these financial relationships and makes it available to the public. These relationships can involve money for research activities, gifts, speaking fees, meals, or travel. One of the ways Open Payments provides this data to the public is through a search tool, which allows an individual to search for a doctor, teaching hospital, or company that has made payments. Exploring this information, and discussing the results found with your healthcare provider, can help to make more informed healthcare decisions.
More information about the program can be found on the Open Payments website http://www.OpenPaymentsData.cms.gov. There you can get an overview of the data that’s been collected and displayed and learn more about the context around the data. For questions about the data, contact the Open Payments team at firstname.lastname@example.org.
Both of my son’s psychiatrists are listed in the Open Payments Data; probably many psychiatrists are on this list since receiving pharmaceutical paybacks is common practice in all specialties. Since this service has only been available since 2014, and two of the most prescribed antipsychotic drugs for schizophrenia, seroquel and risperidone, became available in their generic form in 2014, the kickbacks listed were under $1000 for each doctor. This doesn’t show how much they made while the drugs were still under the original patent name (10 years) or when the patent name prescriptions are written for the government insurance plans to pay.
The first prescription my son’s doctor wrote for us was for Seroquel. The price for a one month prescription of Seroquel was $1600 charged to Medicaid. Quetiapine, the generic form, was $400. The doctor changed the prescription to the generic name only when we requested it. Antipsychotic drugs represent the largest drug expenditure of the government insurance system in the US.
The investigative journalism organization, ProPublica, compiled the Dollars for Docs database of payments to individuals from publically available data from seven US pharmaceutical companies during the period 2009-2010. They examined the cohort of 373 physicians in this database who each received USD $100,000 or more in the reporting period 2009 to 2010. (ProPublica, 2009 – 2010). During this period psychiatrists could only prescribe the original patented form of the drugs.
The investigative journalism organization, ProPublica, published a Dollars for Docs table by specialty for drugs prescribed in 2009 – 2010; it shows that 117 psychiatrists received $125,773 for prescribing anti-psychotic drugs.