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Are Perks Compromising MD Ethics?

WASHINGTON, June 26, 2008
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(CBS) This report was created in special collaboration with
BusinessWeek.

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For five years, Mathy Downing has struggled for an explanation.

Why would her daughter Candace - a happy 12-year-old - hang herself
from the bedpost, leaving no notes and no clue?

"We had no warning," Downing said. "Absolutely no warning."

The Downings blame Candace's suicide on the antidepressant drug
Zoloft.

They wondered why the doctor gave such a powerful drug when Candace's
only complaint was anxiety in school. Then recently, in their lawsuit
against the doctor, they think they found an answer, CBS News
correspondent Wyatt Andrews reports.

"I said, 'wait a second … what?'" said Candace's father, Andy
Downing.

Wait a second, because Candace's doctor, Matheme Selassie, had been
paid around $12,000 making speeches touting Zoloft, with some of the
payments coming from Pfizer, the drug's manufacturer.

The Downings believe the money influenced the prescription.

"Did the doctor tell you he was taking Pfizer money?" Andrews asked
Mathy Downing.

"Absolutely not," she said. "How dare he! How dare he take money for a
medication that killed our daughter."

Today the chances are good your doctor accepts benefits from drug
companies - and not just the free samples and the pens you see in most
doctors' offices.

Estimates say drug-company payments to doctors go as high as $57
billion a year, according to a University of Quebec study, covering
consulting fees, speaking fees on drugs, and medical seminars on the
benefits of drugs.

That means the industry spends far more money marketing to doctors
than it spends on advertising.

"If they are being paid, it ought to be reported," said Sen. Charles
Grassley, R-Iowa.

Grassley is also looking at the money drug companies pay doctors for
academic research. He is investigating some 20 top medical schools -
including Harvard, Stanford and the University of Cincinnati, for
under-reporting the income top researchers are getting from the drug
industry.

Grassley wants to learn if the money is influencing research.

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Read BusinessWeek's "Doctors Under The Influence"
Also: "Drugmakers and College Labs: Too Cozy?"
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At Harvard, for example, Dr. Joseph Biederman, whose research has led
to huge increases in bipolar diagnoses in children - and the
prescriptions to treat those children - is being asked why he
allegedly failed to report $1.6 million in fees from drug companies.

What kind of flag does that raise for Grassley?

"Well, it raises a flag to me that they might have something to hide,"
he said. "It raises a flag that the university doesn't care."

Biederman tells CBS News some of that industry money was "not personal
income," and that his life's work is devoted solely "to rigorous and
objective study."

Fixing this problem is complicated because some relationships between
doctors and drug companies are legitimate, and necessary to achieve
breakthrough therapies. Sen. Grassley says the answer is more public
information.

Grassley and other senators have proposed a law requiring drug
companies to report any payments to doctors of more than $500. That
reporting will be available publically on a government Web site.

"There has to be full transparency," Mathy Downing said. "Parents,
families have the right to all the information."

As for the suicide of Candace Downing, Selassie says in a deposition
he was paid to speak about adult use of Zoloft. He declined further
comment.

Pfizer, in a statement says its paid consulting work with doctors
helps the company learn "how to reduce adverse reactions ... and
improve effectiveness."

But the big question for the Downings is still about the money.

How much of the industry's money is buying legitimate consultations,
and how much of it could be buying the wrong prescription?

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URL: http://www.cbsnews.com/stories/2008/06/26/eveningnews/main4213269.shtml