Editor’s note:
STAT has retracted the article “How pharma sales reps help me be a more up-to-date doctor,” by Dr. Robert Yapundich. It did not meet our standards.
As a matter of policy, we ask all our contributors to disclose payments from industry and other possible conflicts of interest. In this case, the author disclosed no conflicts other than his affiliation with an organization that supports expanding manufacturers’ ability to discuss off-label uses of drugs. In response to reader questions, we contacted Yapundich and he told us he had received more than $300,000 in recent years from pharmaceutical companies, including one he mentioned in the article. He also acknowledged that his organization was funded in part by pharmaceutical companies. We disclosed that information at the bottom of the article on Tuesday.
We also asked Yapundich to address reader questions about the veracity of the central anecdote in the piece. He said the anecdote was accurate as written.
But Yapundich later told HealthNewsReview that the anecdote was not, in fact, accurate. After that interview was posted Thursday afternoon, we contacted Yapundich again and he conceded to STAT that the anecdote was inaccurate.
We then retracted the article.
STAT takes these matters seriously and values the trust of our readers. We regret the lapses.
Good heavens STAT! Perhaps you should start including conflicts of interest on your op-eds. Also, I totally agree with others here that no doctor worth seeing would rely on drug reps as a valuable resource for learning new information about meds. Between CME, conferences, UpToDate, and I don’t know, maybe actual medical journals, there is plenty of less biased resources for staying current.
With many neurologic remedies going through the roof, there is a lot of motivation to cater to neurologists, who with the stroke of the pen (or EHR system) create up to $100,000 per year per patient (so lets say a million if they can get you to write 10 scrips!)
I do unbiased CME online and go to a few meetings every year. The AAN (American Academy of Neurology) is especially recommended.
Pharma Reps are usually very charming, informative and clearly going to give you one-sided biased information touting their medication. To think otherwise is foolish.
For Congress to criticize and limit doctors’ exposure to industry is the pot calling the kettle black.
That said, the author’s critical thinking skills evident in this article are poor enough I would never want him to treat me or a patient of mine. Logical fallacies, unsupported assumptions and nonsensical implications are evident in almost every statement. Preceding commenters have made a good start as well as pointed out his clear conflicts of interest, unreported by STAT News.
Statnews.com has been criticized before for accepting support from PhRMA and individual drug companies and for native advertising. Articles like this clearly show that STAT’s tremendous promise is seriously impaired by such relationships.
The neurologist has a vested interest. Expand manufacturers ability to speak of off label.
the logic in this opinion piece is terrible…i would have expected more from someone with dr. yapundich’s education and training. and agree that he should have disclosed his compensation from sunovion and other pharma companies.
“The drug representative discussed the clinical data, FDA-approved indications, and potential side effects of the new medication.”
firstly, as dr. yapundich and pharma companies well know, drug sales reps are prohibited from discussing “clinical data” for the simple reason that sales reps have no formal scientific background. perhaps dr. yapundich instead meant medical-science liaisons, who are frequently MDs, PhDs or PharmDs and are authorized to discuss scientific data and off-label use, provided they are reacting to a HCP’s question and not proactively sharing data and/or opinions.
secondly, dr. yapundich is correct that it’s “difficult to keep pace with the breakneck speed of research and development.” however, what he fails to mention is that by choosing to attend an office lunch program from one pharma company, he is effectively foregoing the opportunity to attend programs from other pharma companies…there’s only so many lunches one can eat, after all.
so while he may gain useful information from one company, he’s not comparing that information with information from other companies…which means he’s statistically more likely to favor one company’s drug over others.
i would write more but am too irritated to continue.
Thank You!
Dr. Yapundich received over $100,000 in payments from drugmakers in 2016, according to Open Payments. It may be helpful for readers if similar conflicts of interest are disclosed in future op-eds.
Payments data: https://openpaymentsdata.cms.gov/physician/110034/summary
This is terrible the author received $134,000 in payments from pharma in 2015 alone and the article doesn’t mention it.
https://projects.propublica.org/docdollars/doctors/pid/110034
Could STAT please reconcile the following two statements?
a) The author had not heard of a drug for Parkinson’s Disease Psychosis (implied to be Nuplazid, the only drug approved for this condition) until a recent “lunch program” with a drug rep.
b) The author was paid $5,600 on 12/8/2016 (cash, in two payments) by Acadia Pharmaceuticals for “Consulting” regarding Nuplazid, as well as two more payments of $525 on 11/23/2016 (consulting; in-kind services) and $600 (consulting; in-kind services) also regarding that same drug.
(Source for B: CMS’ Open Payments system — https://openpaymentsdata.cms.gov/physician/110034/payment-information )
If STAT is not able to reconcile these statements, it should retract the article.
I agree with Charles: it’s not enough for STAT to update the article “to include Dr. Yapundich’s ties with industry”, you have to clarify this issue as well.
Question for STAT editors, and specifically for Pat Skerrett, who apparently told Health News Review that “he was especially concerned that there might be ‘dishonesty’ in how Yapundich framed the anecdote about Nuplazid — something which he said ‘very well could lead’ to STAT issuing some kind of clarification or correction on the piece.” https://www.healthnewsreview.org/2017/09/tone-deaf-pharma-conflict-interest-stat-piece-praising-drug-reps-fails-disclose-industry-payments/
Dishonesty is already a given here, considering Yapundich didn’t bother to voluntarily disclose his cozy drug industry ties or the hundreds of thousands of dollars he’s “earned” from industry until he was forced to (conflict of interest disclosures that STAT claims are a requirement in its author agreements).
Given that a number of days have already passed since Charles Seife asked these two very logical questions, when might STAT answer the Nuplazid queries – or better yet, simply retract an embarrassingly obvious pharma marketing piece that’s been bought and paid for by industry?
I say you are a scrappy doctor if you rely on 24 yr old pharma reps. I was a pharma rep for 15 years. They feed you scrap like I did. I sold my soul for money. Shame on you Mr/ms doctor if you rely on a very uneducated rep with spoon fed info. Hope I never go to your practice.
Dr. Yapundich has received over $300,000 in payments from drug companies in the past 4 years. This includes nearly $150,000 from Sunovion, which is under FDA review for a drug for the psychotic episodes in Parkinson’s disease mentioned in his piece (https://openpaymentsdata.cms.gov/physician/110034/summary). It is relevant to his essay, and should have been included in the disclosures. What will a little more digging reveal about his arguments in favor of off label prescription? The underlying ethical and legal implications are disconcerting.
Here is a list of the “Associate Members” of the “alliance for Patient Access”
http://1yh21u3cjptv3xjder1dco9mx5s.wpengine.netdna-cdn.com/wp-content/uploads/2017/07/AfPAAssociateMembersJune2017.pdf
Have you heard of Uptodate? This is is a constantly updated reference for current diagnostic and therapeutic options that is unaffiliated with the sellers.
Off label is what brought us the opioid epidemic among other disasters.
“Off label is what brought us the opioid epidemic among other disasters.”
no, it isn’t. please refrain from spreading misinformation.
Mr./Ms King claims I spread misinformation on the impact of off label marketing. Here is a quote form a peer reviewed article on the topic:
Purdue “aggressively” promoted the use of opioids for use in the “non-malignant pain market.”15(p187) A much larger market than that for cancer-related pain, the non–cancer-related pain market constituted 86% of the total opioid market in 1999.17 Purdue’s promotion of OxyContin for the treatment of non–cancer-related pain contributed to a nearly tenfold increase in OxyContin prescriptions for this type of pain, from about 670 000 in 1997 to about 6.2 million in 2002, whereas prescriptions for cancer-related pain increased about fourfold during that same period.
Van Zee, A. (2009). The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy. American Journal of Public Health, 99(2), 221–227. http://doi.org/10.2105/AJPH.2007.131714
Purdue Pharma acknowledged in the court today that “with the intent to defraud or mislead,” it marketed and promoted OxyContin as a drug that was less addictive, less subject to abuse and less likely to cause other narcotic side effects than other pain medications.
http://www.nytimes.com/2007/05/10/business/11drug-web.html?mcubz=3
and from that tuff to find source wikipedia
Responsibility for the damage caused by OxyContin falls most squarely on the marketers and executives who mislead consumers. Certain Purdue executives were criminally convicted for their actions[cite]. Company president Michael Friedman, top lawyer Howard Udell, and medical director Paul Goldenheim each plead guilty to misbranding (specifically off-label promotion, in violation of the False Claims Act) and the three were fined $34.5 Million in total.[1] In addition, each was given three years probation and ordered to perform 400 hours of community service. However, none received prison time.[15]
thanks for the links. sorry if i was harsh, but i think you’re oversimplifying the issue.
purdue pharma was found guilty of fraudulently marketing oxycontin “as a drug that was less prone to abuse, as well as one that also had fewer narcotic side effects.” this is criminal, but *not necessarily* related to off-label use.
there are multiple reasons why we have an opioid epidemic: 1) physicians’ lack of better treatment options, 2) pressure to achieve high patient satisfaction ratings, 3) legitimate patient suffering and other factors. here’s a link (please view the comments from physicians):
http://www.kevinmd.com/blog/2016/04/the-opioid-epidemic-its-time-to-place-blame-where-it-belongs.html
there are both good and bad reasons for allowing off-label use. a few good reasons: 1) prescribing therapies to non-approved populations (e.g., pediatrics) and 2) discovering viable options for rare conditions.
https://sciencebasedmedicine.org/off-label-use-of-prescription-drugs
ultimately, responsibility lies with the prescriber to ensure he or she is prescribing in the patient’s best interests, whether on- or off-label.