Dollars for Docs: A Portland Nurse Is A Top Earner

ProPublica, a Pulitzer Prize-winning online media organization, last month published an exhaustive look at the practice of pharmaceutical companies making payments to medical professionals.

That practice, examined by ProPublica in its Dollars for Docs investigation, is common but controversial. The investigation compiled a database of payments made by seven companies to more than 17,700 medical professionals during 2009 and early 2010. The database only represents a portion of the payments made by Big Pharma (a number of pharmaceutical companies do not yet have to reveal the payments they make; this secretive practice will end in 2013).

Of those 17,700 medical professionals in the database, ProPublica created a list of the 384 medical providers receiving the most money. And interestingly, since only a handful of non-doctors are on the list of top earners, a Portland nurse made the list.

That nurse is Terri Warren (pictured above). A nurse practitioner who is licensed to write prescriptions, Warren is the owner of the Westover Heights Clinic, a 28-year-old facility located at Northwest 23rd and Flanders. According to ProPublica, Warren received $113,000 in 2009 from GlaxoSmithKline, the world's third-largest pharmaceutical company.

Contacted by phone, Warren was direct to WW about the payments she received. She acknowledged there may be a perception that her medical integrity has been compromised, but argued that the opposite was really the case.

Warren's clinic focuses on sexually transmitted diseases and the vast bulk of her practice involves the diagnosis and treatment of herpes simplex. She has a national reputation and is the author of the bestselling herpes book, "The Good News About the Bad News."

Warren said she received the payments from GlaxoSmithKline in 2009 to give several talks around the country to medical professionals about herpes simplex virus, a treatable, though not curable, disease. Warren says herpes simplex virus infects 16 percent of Americans between the ages of 14 and 49.

"Glaxo would arrange dinner programs for me to come and talk to other physicians about herpes," she said. "I did that a lot and the amount that they paid varied from time to time."

Glaxo's reason for the payments seems pretty clear. It made and sold Valtrex, an anti-viral drug used to treat herpes. But Warren pointed out there are other herpes drugs on the market and she would never specifically mention Valtrex during her talks. If asked about the efficacy of one drug over another, she said "I would always say that they are equally effective."

While Warren received $113,000 from Glaxo in 2009, that number dropped to $300 in 2010. Warren says this is because at the end of 2009, the patent ran out on Glaxo's Valtrex and the drug is now being marketed in generic form by a different company.

And from Warren's point of view, the fact she no longer receives money from Big Pharma is discouraging, because she is now no longer educating medical providers about how to treat herpes. "You wouldn't believe how many providers did not know about the value of viral therapy," she said, "and that it can reduce transmission by half."