February 26,2008

Grassley seeks voluntary disclosure of payments by drug companies on continuing education for doctors


Senator Chuck Grassley has asked leading drug makers to follow Eli Lilly’s lead anddisclose the money it spends for continuing education for doctors. His written appeal foradditional voluntary efforts is below, along with a list of the recipients of his letter.

Senator Grassley has been working in recent years to increase transparency in thefinancial relationships between the pharmaceutical industry and the medical community. Lastfall, he and Senator Herb Kohl introduced legislation that would require drug and devicemanufacturers to publicly disclose anything of value given to physicians, such as payments,gifts, honoraria or travel above certain amounts.

Senator Grassley is Ranking Member of the Committee on Finance. “Transparencybuilds both trust and accountability,” he said. “I’m asking other pharmaceutical organizations tofollow Lilly’s lead and show the public there’s nothing to hide.”

February 26, 2008

Miles D. WhiteChairman of the Board and Chief Executive OfficerAbbott Laboratories100 Abbott Park RoadAbbot Park, IL 60064

Mr. Kevin SharerChief Executive OfficerAmgen Inc.One Amgen Center DriveThousand Oaks, CA 91320-1799

Mr. Tony ZookPresident and Chief Executive OfficerAstraZeneca Pharmaceuticals LPP.O. Box 15437Wilmington, DE 19850

James M. CorneliusChief Executive OfficerBristol-Myers Squibb Co.345 Park AvenueNew York, NY 10154

William C. WeldonChairman, Board of Directors and Chief Executive OfficerJohnson & Johnson1 Johnson & Johnson PlazaNew Brunswick, NJ 08933

Bill HawkinsPresident and Chief Executive OfficerMedtronic, Inc.710 Medtronic Parkway, NEMinneapolis, MN 55432

Richard T. ClarkChairman, President, and Chief Executive OfficerMerck & Co., Inc.1 Merck DriveWhitehouse Station, New Jersey 08889

Jeffrey KindlerChief Executive Officer and Chairman of the BoardPfizer, Inc.235 West 42nd StreetNew York, NY 10017

Fred HassanChairman and Chief Executive OfficerSchering-Plough Corporation2000 Galloping Hill RoadKenilworth, New Jersey 07033

Robert EssnerChairman and Chief Executive OfficerWyeth5 Giralda FarmsMadison, New Jersey 07940

Robert L. Parkinson, Jr.Chief Executive Officer and PresidentBaxter International Inc.One Baxter ParkwayDeerfield, IL 60015-4625

James R. TobinChief Executive Officer and PresidentBoston ScientificOne Boston Scientific PlaceNatick, MA 01760-1537

Stephen P. MacMillanChief Executive Officer and PresidentStryker Corporation2825 Airview BoulevardKalamazoo, MI 49002

David C. DvorakChief Executive Officer and PresidentZimmer Holdings345 East Main StreetWarsaw, IN 46580

Daniel J. StarksChief Executive Officer and PresidentSt. Jude MedicalOne Lillehei PlazaSt. Paul, MN 55117-9913

February 26, 2008

Richard T. ClarkChairman, President, and Chief Executive OfficerMerck & Co. Inc.1 Merck DriveWhitehouse Station, NJ 08889

Dear Mr. Clark:

The United States Senate Committee on Finance (Committee) has jurisdiction over theMedicare and Medicaid programs. As a senior member of the United States Senate and asRanking Member of the Committee, I have a special responsibility to protect the health ofMedicare and Medicaid beneficiaries and safeguard taxpayer dollars authorized by Congress forthese programs. This includes the responsibility to conduct oversight of the medical industry,including makers of pharmaceuticals and medical devices.

One important aspect of my recent oversight concerns the financial relationships thatcompanies such as (The Company) have with medical organizations. On this issue, the Eli Lillyand Company (Eli Lilly) has taken an important step to meet the public's demand fortransparency. In response to my investigation of drug company payments for continuing medicaleducation, Eli Lilly voluntarily created a website to disclose its payments to organizations suchas patient groups and medical societies. I commend Eli Lilly for this leadership and lookforward to working with it, and all of the major pharmaceutical and medical device companies,to further increase the sunshine on key financial relationships.

I am writing to ask what steps your company is taking, or planning to take, to enhancethe transparency of your financial relationships with these medical organizations. If yourcompany does not yet have any efforts or plans in place, please explain why not.

I am sure you are also aware of my latest legislation regarding transparency. ThePhysician Payments Sunshine Act, which Senator Herb Kohl and I introduced last fall, requiresdrug and device manufacturers to disclose to the Secretary of Health and Human Services (HHS)anything of value given to physicians, such as payments, gifts, honoraria, or travel above certainminimum thresholds. Companies would also report the name of the physician, the value anddate of the payment or gift, and its purpose, among other information. The Secretary of HHSwould then make this information available to the public on a searchable website. In addition tovoluntary efforts by industry to disclose their contributions to medical organizations, theenactment of this legislation will finally bring transparency to the financial relationships betweenthe physicians themselves and companies such as yours. While this legislation moves throughthe legislative process, it is my hope that we can also bring transparency to the relationshipsbetween industry and medical organizations through more voluntary efforts like those of EliLilly.

In closing, I would appreciate hearing your response to this letter no later than March 10,2008.


Charles E. GrassleyUnited States SenatorRanking Member of the Committee on Finance


USA Today

Tuesday, February 26, 2008

Drugmakers asked to reveal educational grants to doctors

By Steve Sternberg, USA TODAY

Wondering how much money drug companies spend on continuing education for doctors— and who gets all the support?

Eli Lilly & Co. thinks you deserve to know and lists its grants on its website. Pfizer plansto post similar details soon. Despite Pfizer's move, it is among the 15 companies getting a lettertoday from Sen. Chuck Grassley, R-Iowa, asking what they're doing to "meet the public'sdemand for transparency."

If your company does not have any plans in place, the letter says, "please explain whynot."

"Transparency builds both trust and accountability," says Grassley, ranking member ofthe Senate Finance Committee, which oversees Medicare and Medicaid. "I'm asking otherpharmaceutical organizations to follow Lilly's lead and show the public there's nothing to hide."Alan Coukell of the Prescription Policy Project, a non-profit that has taken aim atconflicts of interest in medicine, says: "Sen. Grassley is a bear on this issue. He has multipleongoing investigations. He did a big report last year on continuing medical education and thepotential for the medical industry to bias (programs) they're funding."

The drug industry is famous for spending vast sums on promotion, an estimated $30billion in 2004, according to a study last year in The New England Journal of Medicine.Companies are barred by law, however, from using educational grants — for conferencesthat doctors must attend to keep pace with scientific advances — to promote their own drugs ordevices, experts say. Nevertheless, the finance committee report cited two instances of abuse. Tosettle those claims of improper drug promotion, Warner-Lambert paid $430 million in 2004 andSerono labs paid $704 million in 2005.

Companies can follow the rules and still spend lots of money, judging from an analysis ofLilly's website. In one quarter last year, Lilly spent nearly $20 million on educational grants,much of it going to conferences for medical specialties that rely on the company's biggestproduct lines: neuroscience, endocrinology and oncology.

"You give where you earn," says David Rothman of Columbia University, a study authorand the Policy Project's associate director.

Alan Breier, Lilly's chief medical officer, says Lilly was not pressured to act by publicopinion or Congress and plans to expand the program worldwide. "We started (postingeducational grants) last year as part of our transparency agenda, to build trust and confidence(among patients)," he says. "In 2004, we were the first company to voluntarily post our clinicaltrials and our clinical trials data. We found it was something that patients and doctorsappreciated and embraced."

Cathryn Clary, a Pfizer vice president, says her firm is "quite proud of the funding andsupport we provide" and plans to post this year's first-quarter data soon after the quarter's end.Clary says Pfizer executives are discussing what to disclose next, adding that the ease ofaccessing data on the Internet has greatly increased demand. "We're all struggling with howmuch to reveal," she says. "Stay tuned."