Doctors and teaching hospitals in Arkansas received more than $10 million in payments from drug companies and medical device manufacturers during the last five months of 2013, a federal agency reported Tuesday.
The payments included more than $7.4 million for research and more than $3.3 million for other services, including royalties and fees for consulting and speaking.
The companies also reported that Arkansas doctors owned stakes in the companies totaling $1.4 million.
Among the Arkansas doctors identified in the data, Glenn Davis, a semiretired Little Rock gastroenterologist, was listed as receiving the largest total -- $233,218.91 in royalties from Braintree Laboratories Inc. and Affordable Pharmaceuticals LLC, both based in Massachusetts.
About 20 years go, Davis said, he and another doctor helped develop Golytely, a fluid mixture used to prepare patients for colonoscopies.
"It's been used basically throughout the country and worldwide for the last 20 years or so," Davis said. "It was the primary means of cleaning the colon for a period of time."
The data were released by the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services as part of the open payments program, which was created by the 2010 federal health care overhaul law.
In a news release, the federal agency said officials hope the information will help consumers understand the financial relationships among drug and device companies, doctors and hospitals.
Future annual releases will include a full year's worth of payments starting in June 2015. Agency officials said they also plan to add online tools to allow consumers to more easily search the data.
Nationwide, companies reported making nearly $3.5 billion in payments to 546,000 physicians and 1,360 teaching hospitals, according to the news release.
"We are taking a big step forward in shining a light on these financial relationships between physicians and the health care industry, and teaching hospitals and the health care industry," Dr. Shantanu Agrawal, the deputy administrator at the Centers for Medicare and Medicaid Services, said in a conference call with reporters.
He stressed that "financial ties and relationships between medical manufacturers and health care providers do not necessarily signal wrongdoing.
"The open payments program does not identify which financial relationships are beneficial and which could cause conflicts of interest," Agrawal said. "We are simply making the data available to the public."
The data can be viewed and downloaded at cms.gov/openpayments.
Doctors and other recipients of funds were given 45 days to review the data and dispute any information they believed was inaccurate.
Information identifying the doctors or hospitals receiving payments was removed from about 40 percent of the records, in most cases because of discrepancies about the identification.
Information identifying the recipients of most of the research funding in Arkansas -- more than $7.1 million worth, was removed from the data.
Among the recipients that were identified, the University of Arkansas for Medical Sciences received the largest amount, $118,518.57 in payments from New Brunswick, N.J.-based Johnson & Johnson's Janssen Research & Development.
All but $117 of that amount was in connection with a study on the safety of the long-term use of the drug Sylvant to treat a disease that causes abnormal cell growth in lymph nodes and related tissues, according to the data.
The $117 was associated with a study on the use of the drug Yondelis to treat malignant tumors.
UAMS was also listed as receiving more than $361,000 in payments unrelated to research, including $202,724 in royalties or license fees from Fujirebio Diagnostics, a division of Japanese company Fujirebio Inc., in connection with an "in vitro diagnostic device."
UAMS spokesman Elizabeth Caldwell said she didn't have additional information on the payments Tuesday afternoon.
In addition to Davis, two other Arkansas doctors, both endocrinologists, were listed as receiving more than $50,000 in payments for services other than research.
Adam Maass of Rogers was listed as receiving $60,971.65, including more than $37,000 from the Danish company Novo Nordisk, which makes drugs and devices related to diabetes care.
James Thrasher, a Little Rock endocrinologist, was listed as receiving $55,663.77, including more than $26,000 from Janssen Pharmaceuticals and more than $24,000 from Minneapolis-based Medtronic.
Thrasher said he owns a clinical research center and frequently travels around Arkansas and elsewhere throughout the country to speak to doctors about new drugs and devices. While the companies reimburse him for travel expenses and pay fees, he noted that he also loses money by not treating patients while he's gone.
"What doesn't show up on there is that when I'm gone during the day, my overhead continues," he said.
He said his presentations help educate doctors who otherwise wouldn't know about the products.
"I'm happy in this state, especially with diabetes, that I can go around and be the person to teach other doctors how to use things," Thrasher said.
A phone message left at Maass' office wasn't returned Tuesday afternoon. According to the data, the bulk of his fees were for "services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program."
While doctors are allowed to prescribe any treatment they think will help a patient, makers of drugs and medical devices are allowed to market products only for uses the Food and Drug Administration has reviewed and approved.
In some cases, companies have used their financial links to the medical community to get around that limitation, according to critics.
The payments "really have an insidious corrupting influence on the practice of medicine, research, the development of clinical guidelines and clinical practice," said Michael Carome, the director of health research at the nonprofit watchdog group Public Citizen. "The reason companies pay physicians honoraria and give them gifts and consulting fees is ultimately to influence the prescribing practices of physicians."
The rollout of the information has been plagued by reports of technical errors.
Drug companies have had trouble uploading the data to the government's servers, said John Murphy, assistant general counsel of drug industry lobbying group, Pharmaceutical Research and Manufacturers of America.
Physicians also complained about the process, saying the Centers for Medicare and Medicaid Services didn't give them enough time to review the data that were submitted. After one doctor found payments attributed to him that belonged to another doctor with the same name, the Centers for Medicare and Medicaid Services temporarily suspended the website.
"The physicians had a 360-page instruction manual," said Robert Wah, president of the American Medical Association, which represents doctors. "Then the website crashed. It was a pretty small window to review the data."
For example, one researcher at the Mayo Clinic who was conducting company-funded research was also given a grant for work related to writing up the findings. The grant was recorded as a gift, said Richard Ehman, a professor of radiology and vice chairman of the conflict interest review board at the Mayo Clinic in Rochester, Minn.
"The data aren't inaccurate so much as it's grouped in bundles that don't apply," he said in a telephone interview. "Perhaps the categories aren't specific enough. Some people have looked at the payments and feel the way it's described isn't accurate."
Information for this article was contributed by Caroline Chen, Michelle Fay Cortez and Alex Wayne of Bloomberg News.
A Section on 10/01/2014