Follow the money

Caveat on this rating: Treatment gap figures depend on survey instruments that define who counts as a case, and critics argue those instruments over-count distress as disorder, especially across cultures. The 2004 data are old and coverage has changed. The row uses the figure for what it measures, people meeting survey criteria who received no care, and does not claim all of them need medication.

Caveat on this rating: A debate paper, not a study, and twenty years old. The legal position in either country may have changed since; the row dates the claim to 2006. Supporters of advertising point to real under-treatment of depression and to evidence that adverts prompt some appropriate care. Both positions are printed in the same paper, and this row gives both.

Caveat on this rating: This is an argument paper by a single author, not a study with a comparison group. Sales can rise because unmet need is finally met, because of marketing, or both, and the paper cannot separate them. The stigma it describes was real, and campaigns that reduce stigma have defenders in public health. The row reports what the paper documents, the phrase and the sales, and does not claim the people treated were not ill.

Caveat on this rating: A systematic review of observational studies; the authors rate 21 of 36 included studies at serious risk of bias and note possible publication bias. Association across studies of many specialties and drug classes, not psychiatry specifically. The causal language is the authors' inference from timing and dose response, not a trial result.

Caveat on this rating: The alert describes patterns from enforcement cases and states that no single characteristic is determinative. It cites a trade-group position that speaker programs "help educate and inform other health care professionals about the benefits, risks, and appropriate uses of company medicines." Speaker programs are lawful when the facts and intent do not meet the statute; the alert does not name any company or clinician.

Caveat on this rating: A single reader classified the conclusions and a second reader would move some papers between groups. Payments made before a drug had a brand name are not attributed to it, which understates early money. A paper that names a drug is not always mainly about it. The analysis shows an association and a direction of conclusions; it cannot show that payment influenced any paper, and selection of successful investigators and publication bias are sufficient to produce much of the pattern.

Caveat on this rating: Cross-sectional and ecological to the group: no timing, so it cannot separate payment-then-prescribing from prescribing-then-payment. Part D is one payer; Medicaid and commercial prescribing are not visible. Long-acting injectables and tardive dyskinesia drugs cluster in clinics that treat severe illness, which is also where speakers are recruited. Specialty is as recorded by CMS.

Caveat on this rating: The specialty field is self-reported to the NPI registry; a psychiatrist listed under another first specialty is not counted. Open Payments records what companies report and can be disputed by the physician. The product attached to a payment is the company's attribution. A PubMed name search can miss publications under a different name form and can include a namesake; counts are indicative. A payment is not evidence that a prescription changed; the Annals review in this wave is the evidence on that question.

Caveat on this rating: All therapeutic areas pooled; the psychiatric subset is not reported in the abstract. Trial duration was measured as any pivotal trial of six months or more supporting an indication, not the median length of all trials.

Caveat on this rating: Quality of evidence is graded moderate for efficacy results and low for conclusions by the review itself; the harms comparison rests on four papers and is very low quality. A methodological review of comparisons, not of any single drug.

Caveat on this rating: Thirty trials of four drugs from one class; the authors say so. "Transparent" is defined by agreement between the published and FDA conclusions, a judgement.

Caveat on this rating: Open Payments records manufacturer-reported payments to physicians only; leaders who are not physicians are invisible to it. Funding for the study is not stated in the record we read. A payment is not evidence of influence and the study does not claim one.

Caveat on this rating: CRS figures for FY2027 are the President's request, not an enacted budget. Percent shares are ours, computed from the report's own totals. The report describes the budget; it takes no position on whether the fee share is appropriate, and none is taken here.

Caveat on this rating: General payments include small items such as meals; the count of psychiatrists receiving "any" payment therefore includes people who received one lunch. Funding for the study is not stated in the abstract. No causal claim about prescribing is made by the authors or here.

Caveat on this rating: Written by an HHS office, so it is the department describing its own agency's funding; its review of research on fees and prices is a narrative summary of the literature it found, not a systematic review, and absence of published evidence is not evidence of absence. Figures are FY2022 and earlier; the FY2026 operating plan row carries the current ones.

Caveat on this rating: Open Payments attributes research payments to a named principal investigator; money paid to institutions without a named physician is not captured. Funding for the study is not stated in the abstract.

Caveat on this rating: The licensing line is not broken out by product in the statements; the identification of it with the PsycINFO family rests on the notes' description of annual licences of electronic products and the association's own product listings, not on a figure in the audit. An audited statement is the organization's account of itself, checked by an auditor it pays.

Caveat on this rating: The royalties line combines CPT licensing with credentialing products and licensed data sales; the report does not print CPT alone, so no CPT-only figure is stated. An annual report is the organization's account of itself, audited by a firm it pays.

Caveat on this rating: The 2024 CFR edition is the one read; the section has been amended over time (the ICD-10 effective date shows that) and a later edition may differ in detail. Adoption of a code set is not a finding about its owner's pricing or conduct.

Caveat on this rating: A committee summary is written by the majority staff and carries its framing ("rejecting President Trump's proposed cut"); the dollar lines are the bill's, the adjectives are the committee's. The enacted act text itself was not read.

Caveat on this rating: Flat in nominal dollars is a real-terms cut only by the ordinary meaning of inflation; no deflator is applied here and no real-dollar figure is stated. The FY2027 request is not in this edition of the report.

Caveat on this rating: The judgement that 11 studies were "published in a way that, in our opinion, conveyed a positive outcome" is the authors' reading, and the study covers approvals from 1987 to 2004; the 2022 update finds the gap narrower for newer drugs.

Caveat on this rating: A Form 990 does not itemize industry support, so no figure for pharmaceutical funding is stated or implied here; the association's annual reports, which might, are available only by email request and were not read. A 990 reports what the filer reports. Nothing in it shows money changing a diagnostic decision, and no such inference is drawn.

Caveat on this rating: An operating plan is a spending plan, not an audited outturn, and the plan itself notes it will use carryover balances consistent with the fee agreements. The fee-act sums across programs are ours, not a line the plan prints. Funded by is not controlled by: the plan states amounts, and no inference about review decisions is drawn from it here.

Caveat on this rating: Funding is unknown, not absent: the record could not be read. The seven-in-ten and nine-in-ten figures are the form's own summary of the paper, in a mood-clinic sample where bipolar disorder is common; screens perform worse in general populations.

Caveat on this rating: An affiliation is not a funding statement. The paper's funding line was not readable, so whether Lilly funded the scale is not established and is not claimed; the NIMH grant is on the record.

Caveat on this rating: Sensitivity to change is a legitimate design goal for a trial endpoint and the authors state it openly; the point is transparency about what an approval number measures, not an accusation.

Caveat on this rating: The founding validation is in students; later work in veterans and clinical samples exists and is not summarised here. The cutoff range is the VA's, with its own caveat that population and purpose change it.

Caveat on this rating: Nominal dollars are not inflation-adjusted; the file's own adjusted column is quoted so the two are not confused. A falling stay rate has more than one possible cause and the file does not choose between them.

Caveat on this rating: The AUDIT-C founding validation excluded women; the WHO project spanned six countries with different drinking cultures. The fee-schedule value of the screen was not read and is not stated.

Caveat on this rating: A sum over reporting states is not a national estimate; states that do not report (and the 19 percent of stays in undisplayed payer and age cells) are missing by construction. Counts are of expected payer at discharge, not of what was eventually paid.

Caveat on this rating: Prices change and are given only as of the read date. Being free is a distribution property, not a validity claim; the BDI-II's psychometrics are strong.

Caveat on this rating: The exam's sensitivity and specificity for tardive dyskinesia are not established in this record; the authors themselves say it is not specific. How often it should be repeated is guideline-dependent and not stated here.

Caveat on this rating: A referred sample inflates apparent accuracy relative to general populations; the scales are DSM-IV era and have been carried forward.

Caveat on this rating: A process measure is a legitimate way to make screening happen; the specification's own caution against reflexive prescribing is quoted so the measure is not misread as a prescribing incentive. What the screen pays is in the fee-schedule row.

Caveat on this rating: The coverage decision states a minimum staffing condition, not a standard of care; whether a given clinic meets it is not something the decision can verify.

Caveat on this rating: The plus-or-minus nine percent is a ceiling, not a typical outcome; realised adjustments are smaller and budget-neutral. No per-clinician depression-measure figure exists in any record we read.

Caveat on this rating: MedPAC's estimates are contested by the plans and their trade association; the commission's methods are published and its critics' are not summarised here.

Caveat on this rating: This is the 2026 list; measures enter and leave the ratings by rulemaking, so the finding is dated. Display measures are published and can return to the ratings in later years.

Caveat on this rating: Actual payment varies by locality (the GPCI) and by whether the QPP conversion factor applies; these are national base amounts computed by us. The fee is the direct payment only and says nothing about MIPS adjustments or plan-level risk payments.

Caveat on this rating: The report describes the reclassification and its rationale; it does not quantify the payment effect of moving depression from HCC 59 to HCC 155, and neither does this row.

Caveat on this rating: The mechanics paragraph is a paraphrase, marked as such; measure weighting, bonus points and exceptions make any individual clinician's arithmetic more complicated than one screen equals one point.

Caveat on this rating: The disclosure describes support to the centre that runs the scale for sponsors who must use it, not payment for the scale's creation; the studies themselves were publicly funded. The FDA document is a draft and nonbinding on paper.

Caveat on this rating: The screen's accuracy depends on the reference standard: the 0.88/0.85 figures are against semistructured clinician interviews; against fully structured or MINI interviews the authors report different values. The prevalence gap (31% vs 17%) is across heterogeneous populations and does not by itself show that any one clinic over-diagnoses; it shows what happens when a screen is read as a verdict.

Caveat on this rating: The trials pooled here predate most collaborative-care programmes; the USPSTF's B grade rests on evidence that screening programmes with support improve outcomes, which is not in conflict with Gilbody's null for screening alone. Both are stated. Neither shows that screening harms.

Caveat on this rating: Measure 134 is a process measure and its follow-up plan definition is broad by design; a documented referral counts, and the specification itself warns against reflexive prescribing. Measure 370 is an outcome measure and remission is a legitimate goal. The critique in this trail is about incentives around a screening score, not about the measures' stated intent, which is quoted.

Caveat on this rating: The 0.388 factor comes from a CMS table whose model version and date were not printed on the pages read; it is a pre-2024 numbering and the 2024 model reclassified the category, so treat it as the order of magnitude a coded diagnosis added, not a current price. MIPS adjustments are budget-neutral and most clinicians land near zero; the plus-or-minus 9 percent is the statutory range, not a typical outcome. The OIG figure covers diagnoses of all kinds recorded on HRAs, not depression alone.

Caveat on this rating: One trial of 120 outpatients in a single setting, with pharmacotherapy restricted to two drugs; the review's 'virtually all' spans heterogeneous designs. The effect size is large and consistent with the wider literature, but this is not the same evidence tier as the meta-analyses in stops 2 and 3. The claim that the measures do not pay for the conversation is an observation about the measure definitions quoted in stop 4, not a finding of any study.

Caveat on this rating: Funding a tool is not the same as biasing it: the PHQ-9's accuracy has since been tested in an independent individual-participant meta-analysis of 58 studies (stop 2), and the tool is free precisely because of the grant. What the grant bought is reach, not a rigged score. The GAD-7 funding statement was read from the instrument's own attribution, not from the 2006 paper's text.

Caveat on this rating: Two pairings are mandatory. On the evidence: educational meetings do change practice at moderate certainty (Cochrane CD003030.pub3, 2021, 215 studies), and physician-industry interaction is associated with prescribing (Brax, PLoS One 2017, pooled OR 2.52, 95% CI 1.82-3.50, moderate quality) - but only TWO studies in that review examined industry-funded CME specifically, one at high risk of bias, published 1988 and 1992, neither measuring clinical outcomes; the most-cited (Orlowski, Chest 1992) measured prescribing after physicians were flown on "all-expenses-paid trips to popular sunbelt vacation sites", conduct Standard 4.1.c now prohibits. On the accreditor: the review most often quoted for "no evidence of bias" (Cervero and Gaines 2014) was commissioned and funded by the ACCME, as its own cover states, and its finding is symmetrical - no data-based article supports OR refutes the assertion. The register is disclosure, never accusation: you should know who pays.

Caveat on this rating: The domain label is load-bearing, per the verified record: the primary-sourced pressure case here (the Annals advertising pullback) is a MEDICAL-JOURNAL case, not a consumer-news case, and the body says so in those words. No news-side adjudicated case exists; no "pharma funds X% of TV news" figure has any federal or peer-reviewed basis (the viral personalization is fact-checked False, PolitiFact 2023); and the pharma advertising-revenue-to-coverage causal literature is absent. The absences print as content - presenting the journal case as a news-media case would be the overreach this row exists to avoid.

Caveat on this rating: What is measured versus what is asserted, per the framing rule in the verified record: these three studies measure coverage QUALITY - benefits inflated, harms omitted, conflicts undisclosed - and none of them measures why. No robust empirical literature links pharmaceutical advertising revenue at an outlet to that outlet's drug-safety coverage decisions (the classic ad-revenue studies are about tobacco, a different industry, and are not presented as pharma evidence). This row presents the measured record and asserts no cause; "media buries drug harms because pharma pays them" publishes beyond the evidence and is on the do-not-publish list.

Caveat on this rating: The built-in rebuttal is structural, per the verified record: BOTH directions print together, always. A brand-name request quintupled prescribing where antidepressants are not clearly indicated (55% vs 10%) AND requests cut undertreatment of real depression (minimally acceptable care 56% without a request, 90-98% with one) - the authors' conclusion is that DTC advertising "may have competing effects on quality, potentially both averting underuse and promoting overuse". The chain also stays explicit: Kravitz tests requests, not ads; the ads-to-requests link is the review tier (Mintzes 2012). "Ads make doctors prescribe" is on the do-not-publish list.

Caveat on this rating: The mandatory rebuttal, printed beside the guidance annotation per the verified record: Rosenthal et al., NEJM 2002 (doi:10.1056/NEJMsa012075) - "the initial surge in direct-to-consumer advertising preceded the 1997 FDA guidelines... and thus the 1997 guidelines may not have been the most important reason" for the increase. The 1997 draft and 1999 final guidance are rendered as annotations ("the rules changed here"), never as the asserted cause of the spend curve - and DTC advertising was never illegal, so "legalized" appears nowhere in this row.

Caveat on this rating: The DSM panel counts are from 2006 and 2012 - historical, not current. The American Psychiatric Association's rebuttal is shown beside the Cosgrove counts because the two figures count different groups in different years, and both are correct as stated.

Caveat on this rating: The overtreatment figure is an aggregate estimate with a wide band, not a finding about anyone's individual care. Population-level effects of payment systems say nothing about any individual clinician's reasoning, and the research does not claim otherwise - nothing here says your doctor is motivated by money.