Iowa doctors get more than $12.6 million in outside payments

Iowa doctors received more than $12.6 million in payments from pharmaceutical companies and medical manufacturers in 2015 — with one Iowa City doctor's payments accounting for about a third of overall payments — according to data recently released by the federal government.

The payments range from a $15 lunch to thousands in consulting fees and royalties. Some Iowa doctors were given thousands of dollars to travel internationally to places including Frankfurt, Germany, Dubai, United Arab Emirates, and Bangkok, Thailand, while others were given gifts valued at anywhere from $2,000 to more than $43,000.

Highest paid doctors in Iowa

The federal Open Payments program, which put out new data last week by the Centers for Medicare and Medicaid Services, requires drug and medical manufacturers to release details of the payments they make to physicians and teaching hospitals for services such as promotional talks, consulting, and research and royalty agreements.

CMS has released data twice — the first data collection detailed payment made between August 2013 through the end of 2014. The most recent data release included payments made from Jan. 1, 2015, to Dec. 31, 2015

Health care industry manufacturers nationwide reported $7.52 billion in payments in 2015. About 618,000 physicians and 1,110 hospitals from across the country received payments, according to CMS data.

That breaks down to about:

• $2.6 billion in general payments, including food, travel and consulting fees

• $3.89 billion in research payments

• $1.03 billion in ownership or investment interests.

These payments are not inherently bad or illegal, experts have said, but relationships between doctors and medical manufacturers can produce conflicts of interest, which is why it is important to disclose these relationships.

'Transparency is empowering physicians to be purposeful about their financial relationships with companies, and there is a notable shift toward charitable contributions and away from other interactions such as honoraria and gifts,' said Dr. Shantanu Agrawal, a CMS deputy administrator and director of the Center for Program Integrity, in a news release.

In Iowa in 2014, physicians were given more than $69,200 in charitable contributions compared with more than $70,000 in 2015.

A Gazette analysis of the data revealed that while some doctors receive only a handful of small payments, others are paid millions of dollars.

Dr. John Callaghan, an orthopedic surgeon at the University of Iowa Hospitals and Clinics, received more payments than any other doctor in the state. Callaghan was paid more than $4.27 million in 2015 from Massachusetts-based DePuy Synthes Products and related companies, and has been paid more than $10 million since August 2013.

Data shows that Callaghan received about $63,000 worth of consulting fees and about $4,654 for travel, lodging and food. But the vast majority of payments were from royalties and licensing — $4,220,719.

Callaghan said the payments are related to intellectual property transfer and design of 10 to 15 hip and knee implants over a 20-year period, adding the money has allowed him to give back to the University of Iowa.

After Callaghan, the physician to bring in the second largest sum of payments was UIHC's Dr. Annunziato Amendola, who was paid more $943,929 from August 2013 to the end of 2015. Amendola recently took a position at Duke University Hospital in Durham, N.C.

• Iowa medical doctors brought in the most payments — more than $25,100,000 since 2013.

• The state's dentists received more than $1,330,000.

• Doctors of osteopathy more than $1,200,000.

• Podiatrists received more than $603,000.

Pharmaceutical giants, including New Jersey-based Novartis Pharmaceuticals Corp. — the country's largest in sales of prescription medicine — and New York-based Pfizer Inc. — No. 2 — are among the top payers in the state. Novartis paid out more than $3.6 million to doctors, and Pfizer paid doctors more than $2.6 million between August 2013 to December 2015.

The top payer in Iowa was orthopedics manufacturer and designer DePuy Synthes Products, which paid about $9.9 million during that same time period.

By the numbers

Health care industry manufacturers nationwide reported in 2015:

• $7.52 billion were made in payments to approximately 618,000 physicians and 1,110 hospitals.

• $2.6 billion were made in general payments, including food, travel and consulting fees.

• $3.89 billion were made in research payments.

• $1.03 billion were made in ownership or investment interests.

In Iowa

• In 2014, physicians were given more than $69,200 in charitable contributions.

• In 2015, they received more than $70,000.

Companies that gave the most money:

1 DePuy Synthes Products — $9,945,141

2 Novartis Pharmaceuticals — $3,637,624

3 Amgen Inc. — $2,800,774

4 Eli Lilly and Co. — $2,727,036

5 Pfizer — $2,655,450

Source: Open Payments