Big Pharma's giant promotional payouts to doctors

More than 700 doctors were paid at least $1 million by drug and medical device companies between 2014 and 2018, ProPublica reports. More than 2,500 received at least half a million dollars.

Why it matters: Many drugs that are heavily promoted have strong competition. "Promotional spending is a major way that manufacturers in these situations distinguish themselves from each other — not by conducting comparative studies or by engaging in substantial price reductions," said Aaron Kesselheim, a professor of medicine at Harvard Medical School.

Between the lines: The Affordable Care Act required such payments to be made public. While some experts thought transparency may cause companies and doctors to rethink the payments, that doesn't seem to have been the case.

• Doctors were paid for activities like dinner talks, sponsored speeches or consulting on products.

By the numbers: In each of the 5 years, drug and device companies spent between $2.1 billion and $2.2 billion paying doctors. Around 600,000 doctors received payments each year.

Go deeper: Read the investigation