Managed Care

Psychiatrists paid well by drugmakers

It isn't only patients who dig deeply into their pockets to pay the shrink. Drug company payments to Vermont psychiatrists more than doubled in 2006, to an average of $45,692 per doctor, up from $20,835 in 2005, according to a report from the state attorney general. As states require drugmakers to disclose payments to doctors for lectures and other services, it appears that psychiatrists earn more from drugmakers than other specialists do. The second best paid specialists were endocrinologists, who earned an average of $33,730. The analysis identified only the top 100 earners, with 11 psychiatrists and five endocrinologists in the group. The sixteen internists in the top 100 received the third largest amount, $150,209, with an average of $9,388. In 2005, the 14 internists in the top 100 received $124,238, with an average of $8,874.

One osteopath was included in the top 100. This physician received payments of $46,642 — the highest average and median payment per prescriber in the top 100 in 2006.

"We don't think any other states have engaged in the in-depth data analysis that we have," says Julie Brill, assistant attorney general.

Other states are also taking steps to monitor payments made to prescribers. As of January, five states (California, Florida, Maine, Minnesota, and West Virginia) and the District of Columbia have laws or regulations pertaining to pharmaceutical marketing disclosures that concern payments.

Vermont's most highly paid doctors, by specialty
($ in thousands)
Specialty Number of recipients Total received Average per recipient Percentage of overall total
Psychiatry 11 $503 $46 22.4%
Endocrinology, diabetes, and metabolism 5 $169 $34 7.5%
Internal medicine 16 $150 $9 6.7%
Neurology 5 $115 $23 5.1%
Other 7 $71 $10 3.2%
Family practice 12 $71 $6 3.2%
Oncology 3 $59 $20 2.6%
Ionizing Radiation Privileges 9 $55 $6 2.5%
Osteopath 1 $47 $47 2.1%
Pediatrics 4 $43 $11 1.9%
Note: Percentages do not add up to 100 because these are only the top 10 specialties to receive payment.
Source: Pharmaceutical marketing disclosures. Report of the Vermont Attorney General William H. Sorrell. June 26, 2007

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