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D.C. Doctors Are Cleaning Up with Drug Company Gifts

They probably are wherever you live, too.

In 2004, the District of Columbia passed the AccessRx Act. Its provisions include some impressive checks against Big Pharma, including requiring them to enter into rebate agreements with the district under threat of public shaming, and various provisions for low-income/uninsured access to prescription drugs. Tacked onto it are also some transparency requirements that, bizarrely, aren't federal law (quite yet), such as forcing pharmacy benefit managers to disclose conflicts of interest and forcing pharmaceutical companies to disclose their total marketing expenditures. In D.C., unlike the rest of America, if you're dumping tons of money on docs, you have to say so.

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Of course, dumping tons of money on doctors in the form of gifts should be illegal for drug companies, but not being able to do it in secret is at least something. At the very least, it gives researchers like George Washington University's Susan F. Wood a window into the gift pipeline, so that folks like you and I can better understand that your doctor might have interests beyond you and your health. If you're a district resident, some of those interests might have to do with the $84 million spent on marketing in D.C. in 2011, which works out to be about $132 per city resident, or about a health insurance premium payment for one young, reasonably healthy human.

That $84 million figure comes courtesy of Woods and her team, who parsed the AccessRx data to not particularly pretty results. 22 percent of that $83 million went to so-called "gifts," e.g. grants, food, speaker's fees. $100,000 of that went to just 12 individual doctors (though the report doesn't name names). Other findings:

Out of nearly 3,400 physicians in the District who received at least one food gift, 444 received ten or more meals from pharmaceutical companies during 2011 and 33 physicians got 52 or more of these food gifts. This finding suggests some physicians are dining with drug reps on a weekly basis.

The top ten professional organizations (representing health professionals in a specific specialty or demographic group) received a total of $3.5 million, with half of those gifts valued at $20,000 or more.

The top ten Disease-Specific Organizations based in the District received $2.1 million in gifts such as cash or checks from drug companies. These organizations often represent and advise patients, and the concern is that large gifts could sway such groups to favor or recommend the company's products, the report said.

Worth mentioning is that the Affordable Care Act phases in something like D.C.'s transparency requirements next year. So, we're looking to see some wild numbers in the very near future. Extrapolate D.C.'s "gift" rate to a New York-size population or, yeah, the nation at large. It's gross. This is prime time for Big Pharma bullshit-callers.

Reach this writer at michaelb@motherboard.tv