Evelyn Pringle June 2009
From 1998 through 2007, there were 8,700 trips by Department of Defense personnel paid for by the healthcare industry, with a price tag of more than $10 million, according to a new report titled, “Pentagon Travel,” by the Center for Public Integrity.
In a joint project with Northwestern University’s Medill School of Journalism, the Center reviewed travel disclosure forms filed by DOD personnel, and found the medical industry was the largest sponsor of free travel, accounting for about 40% of all trips.
The sponsors included drug and device makers as well as health foundations and trade groups often funded by those companies.
“Drug companies and device manufacturers spent about $1.7 million for more than 1,400 trips taken by DOD doctors, medical researchers, pharmacists, and other health care employees over the decade, creating relationships that pose serious conflict of interest issues, according to medical ethics experts,” the Center said in a June 9, 2009 summary of the study on its website titled, “Medical Industry Showers DOD with Free Travel.”
“Of special interest to the industry were DOD employees who prescribe, purchase, or recommend the use of drugs or medical equipment,” the summary notes.
DOD’s pharmacy system employees, who can influence which drugs are selected at base pharmacies, took more than 400 trips, worth over $400,000, from medical industry sources, according to the Center’s analysis.
The review found drug companies paid more than $115,000 for trips to destinations that included Orlando, Las Vegas, San Diego, New York City, New Orleans, Paris, and Rome.
“They pay for them because it works,” says Thomas Murray, president of the Hastings Center, a nonpartisan bioethics research institute, in the summary. “Trust me, their marketing departments are paying very close attention to cost benefit analysis for these kinds of gifts.”
Shahram Ahari worked as a sales representative for Eli Lilly in 1999 and 2000, and described how he used free meals, trips, and unrestricted grants to subtly seduce civilian physicians into prescribing Lilly’s drugs.
The strategy, he explained, is to make friends with doctors and pharmacists to get them talking about the drugs or devices, and then reward them with additional perks for prescribing the drugs.
“The return on dividends is phenomenal,” Ahari said in the summary. “If it costs them a thousand dollars for a dinner, that’s a [patient’s drug] payment for one month.”
“If they fly you on the Concord to Paris for five grand, even if they get one patient out of it, it’s a lifetime of cash,” he pointed out.
From fiscal year 2000 to fiscal year 2006, the Pentagon’s prescription drug spending more than tripled from $1.6 billion to $6.2 billion, according to an April, 2008 Government Accountability Office report.
The head of the DOD’s pharmaceutical program, Rear Admiral Thomas McGinnis, banned his own staff from going on company-paid trips, but other military pharmacy staff took about 400 trips, the Center points out.
Drug spending hit $6.8 billion in 2008, said McGinnis, and “the GAO expects DOD pharmaceutical spending to reach $15 billion by 2015,” according to the summary.