Few days went by last year when New Hampshire totaled $5,959. She declined to comment when nephrologist Ana Stankovic didn't receive a reached on Tuesday. payment from a drug company. "There are physician practices which have very All told, 29 different pharmaceutical companies deep relationships with pharmaceutical paid her $594,363 in 2014, mostly for promotional representatives, where they are a very integral part speaking and consulting, but also for travel of the practice," said Dr. Aaron Kesselheim, an expenses and meals, according to data released associate professor of medicine at Harvard Medical Tuesday detailing payments by drug and device School who has written about industry companies to U.S. doctors and teaching hospitals. relationships with doctors. "Every day it's another drug company coming in for a lunch. Sometimes it Stankovic's earnings were certainly high, ranking may be some drug companies are bringing her about 250th among 606,000 doctors who breakfast and some are bringing lunch and it's just received payments nationwide last year. What was part of the culture of the practice." more remarkable, though, was that she received payments on 242 different days -nearly every Sometimes there may be more at work than that. workday of last year. The doctor with the second-highest number of Reached by telephone Tuesday, Stankovic declined interactions with drug and device reps, John Fritz, to comment. On her LinkedIn page, Stankovic lists of Jersey City, N.J., logged payments on 256 days herself as vice chief of staff at Parkland Medical last year. His payments totaled $232,003. Fritz Center HCA Inc. in Derry, N.H., and as medical was indicted in June for referring patients to a director of peritoneal dialysis at Da Vita Inc., also in medical imaging company from 2006 to 2013 in Derry. exchange for about $500,000 in kickbacks. That doctors receive big money from the The drugs for which Stankovic received the most pharmaceutical industry is no surprise. The latest money to promote are costly. One, H.P. Acthar data released by the Centers for Medicare and Gel, cost an average of nearly $39,000 a Medicaid Services shows that such interactions are prescription, Medicare data from 2013 shows, widespread, with not only doctors, but thousands and experts say there's little evidence it works of dentists, optometrists, podiatrists and better than less expensive drugs. Another chiropractors receiving at least one industry drug, Soliris, for which Stankovic received payment from August 2013 to December 2014. promotional payments is among the most expensive drugs in the world but is considered What is being seen for the first time now is how highly effective in treating serious kidney disease. ingrained pharmaceutical companies and their sales reps are in the lives of those who write ProPublica's analysis turned up big differences in prescriptions for their products. A ProPublica the number of industry interactions among analysis found that 768 doctors received payments physicians in different specialties. On average, on more than half of the days in 2014. More than doctors who received payments interacted with 14,600 doctors received payments on at least 100 drug and device companies on 14 days last year, days in 2014. receiving an average of $3,325 in total. Take Juichih Hsu, a Maryland doctor whose The nation's 3,900 rheumatologists in the data specialty is family medicine. She received payments averaged 40 days of interactions with drug and on 286 days of 365, more than anyone else. device companies, more than doctors in any other Sometimes, she received meals from several drug large specialty. They were followed closely by companies on the same day. Hsu's payments endocrinologists, electrophysiologists andinterventional cardiologists. On the other end of The government initially released some data last the spectrum, dentists, chiropractors, fall, covering the period of August to December neonatologists and pathologists had among the 2013, but it was significantly redacted because of fewest interactions with drug and device makers. data inconsistencies. The data released Tuesday covers the period of August 2013 to December A spokeswoman for the pharmaceutical industry 2014. The data inconsistencies have been resolved. said in a statement that company interactions with doctors are important. "Collaboration between All told, 1,617 companies reported 15.7 million physicians and biopharmaceutical professionals is payments valued at $9.9 billion. Nearly all of those critical to improving the health and quality of life of payments - 14.9 million - were classified as patients," the statement from the Pharmaceutical "general payments," covering promotional Research and Manufacturers of America said. speaking, consulting, meals, travel and royalties. They totaled $3.5 billion over the 17-month period. ProPublica has been tracking industry payments to doctors since 2010. Our Dollars for Docs There were far fewer research payments, 826,000, interactive database allowed people to search but they were valued at $4.8 billion. The remaining payments made by 17 companies between 2009 and payments related to ownership or investment 2013. Most of those companies were required to interests that doctors had in companies. Research report their payments as a condition of legal and ownership payments are currently not shown settlements with the federal government. in Dollars for Docs. The data released Tuesday radically expands the Open Payments does not include money spent on amount of data available to patients. ProPublica has drug samples left at doctors' offices and doesn't overhauled Dollars for Does to include these include the bulk of the money companies spend on payments. The Physician Payment Sunshine Act, a independently administered continuing medical part of the 2010 Affordable Care Act, mandated education, which they support with unrestricted that all drug and device companies publicly report grants. The government has tightened the rules for payments to doctors. The transparency effort is reporting such continuing education in the future. called Open Payments