What the best-paid psychiatrists publish about the drugs that pay them

this page does not question a single scientific finding. it asks a simpler question that the reader of a journal is almost never helped to ask: when a leading psychiatrist writes about a drug, is the drug’s maker paying them, and which way does the paper come out? we took the federal payment records and the published papers, put them side by side, and read every conclusion.

1. which way the papers come out

ten of the twenty best-paid psychiatrists publish. together they wrote 451 papers from 2019 to 2026. 129 of those are about a branded drug whose maker paid that same author at least $10,000 between 2021 and 2024. we read the concluding sentences of every one.

set aside the 29 neutral papers (mechanism studies, pharmacokinetics, trial designs, corrections) and 100 remain that reach a verdict on the drug. 93 of them, 93%, are favorable. 6 are mixed or cautious. 1 reports a trial that did not meet its goal. not one concludes that the drug does not work or questions whether it should be used. 19 of the favorable papers go further and argue for a new use, a new group of patients, or using the drug earlier. 82 of the 129 papers, 64%, list a co-author employed by a drug company.

2. is the overlap random?

ten authors and 23 branded drugs make 230 possible pairings. where the maker had paid the author $10,000 or more for the drug, the author had published on it 42% of the time. where it had not, 15%. of all their papers, 163 name a brand still under patent and 48 name only generic drugs, in a field where the twenty promoted brands are 2.3 percent of prescriptions.

3. three jobs, one small group

4. the other explanations, which may be the right ones

• selection, not influence. companies hire the people who ran a drug’s successful trials. those people were going to write favorable papers because the trials were positive. payment follows the finding.
• nobody publishes nothing. journals and authors rarely write up a null result. Turner found that a third of FDA-registered antidepressant trials were never published, and the unpublished ones were mostly the negative ones. a favorable literature can be built from honest papers.
• sponsorship bias is measured, and it is subtle. Cochrane found industry-sponsored studies reach favorable conclusions more often (risk ratio 1.27) with methods that look as clean as anyone’s. the tilt comes from which question is asked, which comparison is chosen and how the conclusion is worded.
• these are drugs that passed. every product here was approved by the FDA on positive trials. a paper saying it works is, to that extent, saying what the regulator found.

none of that makes the relationship unimportant. it is why it matters that the reader can see it. a consensus statement recommending a drug as first-line treatment reads differently when you know its authors are paid by the maker. the information is public. almost nobody is shown it.

5. every paper, so you can check our reading

each row links to PubMed. “paid” is the amount Open Payments shows that author received in connection with that drug from 2021 to 2024. the verdict is ours, from the abstract’s conclusion.

method and limits

• payments: CMS Open Payments general payments, 2021 to 2024, psychiatry specialties, summed per prescriber number; the twenty largest 2024 totals define the group. payments made before a drug was approved carry no product name and are not counted toward that drug, which understates early money.
• papers: every PubMed record from 2019 to 2026 for each author. ten authors return reliable results. the other ten have no meaningful record or names too common to search, and are left out of the paper counts. a paper counts toward a drug if the brand or generic name appears in its title or abstract.
• verdicts: one reader, the concluding sentences of the abstract. corrections, replies and papers with no abstract are counted as neutral.
• roles in the Venn diagram come from each organization’s own website and are the least certain part of this page.

Sources

1. CMS. Open Payments general payment data, program years 2021 to 2024, summed per prescriber number and product. Our arithmetic, 2026-09-20. https://www.cms.gov/priorities/key-initiatives/open-payments/data
2. National Library of Medicine. PubMed records 2019 to 2026 for each author, retrieved through E-utilities 2026-09-20; drug names matched in title and abstract; conclusions read and classified by veisund. https://pubmed.ncbi.nlm.nih.gov/
3. Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev 2017;2:MR000033. https://doi.org/10.1002/14651858.MR000033.pub3
4. Mitchell AP, Trivedi NU, Gennarelli RL, et al. Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? A Systematic Review. Ann Intern Med 2021;174(3):353–361. https://doi.org/10.7326/M20-5665
5. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 2008;358(3):252–260. https://doi.org/10.1056/NEJMsa065779
6. HHS Office of Inspector General. Special Fraud Alert: Speaker Programs. 16 November 2020. https://oig.hhs.gov/documents/special-fraud-alerts/865/SpecialFraudAlertSpeakerPrograms.pdf

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