Area doctors paid by Eli Lilly: Several Roanoke health care providers have received payments from the drugmaker this year.

Aug 13, 2009 (The Roanoke Times - McClatchy-Tribune Information Services via COMTEX) -- LLY | Quote | Chart | News | PowerRating -- The drug company Eli Lilly and Co. pumped $60,562.50 into the pockets of Roanoke doctors and other health care providers during the first three months of the year.

The vast majority of the payments in Roanoke went to doctors specializing in endocrinology and psychiatry. The highest payments in Roanoke went to two psychiatrists, Dr. David Scheiderer and Dr. David Trinkle. Additionally, doctors at Roanoke-based Endocrinology Associates were among the biggest local recipients of payments from Lilly.

The registry of payments to individuals recently released by the company offers the first glimpse at just how much drug companies pay doctors. But Lilly's registry comes as political pressure has forced many of the world's largest pharmaceutical companies to offer more transparency in how they pay doctors and researchers.

Critics of the relationship between drug companies and doctors suggest the payments may pose a conflict of interest when doctors treat patients.

"This registry is consistent with Lilly's efforts to increase transparency," said Dr. Jack Harris, Lilly's vice president of its U.S. medical division, in a news release. "We see greater transparency as integral to rebuilding trust in our industry."

Other pharmaceutical companies, including Pfizer, have said they would begin disclosing payments to physicians.

The payments in Roanoke ranged from $300 to $21,300, with some individuals providing services to Lilly multiple times during the three months.

In all, nearly 3,400 physicians and other health care professionals were listed on the registry as being paid by Lilly. The company limits compensation to no more than $75,000 in a calendar year.

Scheiderer, a Roanoke psychiatrist who also runs an independent consulting firm, Tiberius Enterprises, worked for Lilly on 13 occasions, earning a total of $21,300. Of that, $18,300 was categorized as for professional educational services and $3,000 was for consulting work.

Trinkle, who is a geriatric psychiatrist with the Carilion Center for Healthy Aging and a Roanoke city councilman, earned $12,000 from Lilly. His payments came from serving as a speaker at professional educational programs on six occasions.

New rules coming

Trinkle said he supports increased transparency and has always talked about multiple treatment options during his lectures. He also said he hasn't done a lecture for Lilly since January and thought some of the payments were likely from lectures he gave in 2008. He said he is purposefully scaling back on lectures for all drug companies.

"Really I haven't done much lately," he said. "The philosophy at Carilion is changing. And I've taken on new roles within Carilion that makes it both impractical and not the best thing to do."

Specifically, Trinkle said he is more involved with the upcoming Virginia Tech Carilion School of Medicine and doesn't have the time to devote to leading educational seminars.

Carilion is in the late stages of developing policy regarding pharmaceutical companies and honorarium to employed physicians and the medical school staff.

"We've been discussing it and I think will have something in place before the medical school opens," said Carilion spokesman Eric Earnhart. The school is set to open next August.

"It is definitely to address the issue of conflict of interest and make sure that everyone is aware of what physicians are doing and who's funding it," Earnhart said.

Trinkle said the growing concern over conflict of interest is not the only change happening with the relationship between doctors and the drug industry.

"They've changed the rules so much that I have to give a scripted slide presentation," Trinkle said of his most recent lectures for Lilly. "I'm not able to talk about how I treat or my patients. ... It's gotten to the point where you have to talk about one medication."

Trinkle said he felt more comfortable and that the lectures had a stronger impact when he didn't have to follow the script.

Dr. Richard Claytor, another Roanoke psychiatrist, earned $8,050 providing professional educational services on six occasions.

Lilly's best-selling drug is the schizophrenia medicine Zyprexa. The company reported $1.2 billion in revenues for Zyprexa during the three months ended June 30, the latest financial results available. The company has faced legal troubles involving the drug as reports of serious side effects, including diabetes, have surfaced among long-term users.

Lilly's second best-selling drug is Cymbalta, which is used for treating depression and anxiety. Revenues for Cymbalta totaled $744.4 million for the three months ended June 30.

In addition to selling neuroscience drugs, Lilly also has a significant presence in the treatment of diabetes, making insulins such as Humulin and Humalog. Lilly saw revenues of $248.1 million for Humulin and $477.5 million for Humalog for the three months ended June 30.

While endocrinologists treat a variety of hormone-related diseases, the most common endocrine disease in the United States is diabetes.

Three doctors at Endocrinology Associates worked for Lilly a total of 18 times during the first three months of the year leading educational program for their peers. Dr. James Mulinda earned $8,787.50 for providing services to Lilly on 10 occasions. Dr. Michael Koch worked for Lilly four times and earned $4,275. And Dr. James Bailey worked for Lilly four times and earned $3,750.

Besides Trinkle, none of the Roanoke doctors paid by Lilly returned calls seeking comment.

Voluntary disclosures

Lilly announced in September it would begin to voluntarily disclose physician payments starting in the second half of 2009. But the company said in its news release that in February it entered into an agreement with the Office of Inspector General at the U.S. Department of Health and Human Services and was required to disclose the information.

"Our contracted faculty are key resources in our efforts to improve individual patient outcomes," Harris said. "They advise us on how to bring the best new cures and treatments to market, and give lectures to their peers on Lilly products and disease-state information to help keep them current on the ever-changing field of medicine."

Health providers throughout Virginia were among those earning money from the drug company, including in Lynchburg, where payments to five providers totaled $39,037.50.

Sens. Chuck Grassley, R-Iowa, and Herb Kohl, D-Wis., introduced the Physician Payments Sunshine Act of 2009 in January. The bill seeks to establish a public record by requiring the makers of drugs, devices and medical supplies to report payments to doctors to the Department of Health and Human Services.

In July, Kohl, who chairs the Senate Special Committee on Aging, held a hearing on the need for more transparency on the financial relationships between the medical industry and physicians.

Eric Campbell, an associate professor at the Institute for Health Policy and the Department of Medicine at Massachusetts General Hospital and Harvard Medical School, was among those who testified in favor of creating a public disclosure record.

"A public record like this could serve as a deterrent to inappropriate relationships and undue industry influence," he said in his prepared testimony.

Campbell also acknowledged that society relies on the research partnerships between the industry and the medical community for advancement in patient care.

"Although patients and the public benefit from constructive collaborations between academic medicine and industry, particularly in moving discoveries from basic science into improved patient care, financial ties between medicine and industry can create significant risks that these relationships will inappropriately influence doctors' judgments and actions," he said.

"Conflicts of interest jeopardize the integrity of scientific research and also threaten the objectivity of medical professionals' education, affect the quality of patient care, and erode the public's confidence in medicine."

Online: www.lillyfacultyregistry.com

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