In the first revelation about how much drug makers are paying doctors, Eli Lilly has created an online registry detailing payments to 3,400 healthcare providers -- including more than two dozen in South Florida in the first three months of this year.

Top on the South Florida list -- and No. 3 in the nation -- was internist Manuel Suarez-Barcelo, who told The Miami Herald that he earned $65,000 by traveling through 11 states, making 41 presentations, mostly to nursing home staff, about the advantages of the Lilly drug Forteo, used to treat osteoporosis.

Seven others in South Florida pulled in more than $10,000 each, including Broward obstetrician-gynecologist Jay S. Cohen, who received $38,000.

The payments are not illegal, but Washington policymakers question whether they raise the potential for conflicts of interest.

As Congress looks for ways to reduce healthcare costs to help fund the nation's 50 million uninsured, several leading lawmakers have expressed concerns that drug makers lavish payments on doctors to influence them to prescribe the latest, and often most expensive, drugs.

``Large corporations do not typically spend these sums unless they think they will get something out of it,'' said Sen. Herb Kohl, a Democrat from Wisconsin, in a Senate hearing last month. Kohl and Sen. Charles Grassley, a Republican from Iowa, are pushing for federal legislation to require all drug makers to reveal what they pay doctors

DRUGS PROMOTED

Grassley-instigated investigations have found cases like that of an Atlanta psychiatrist, Charles B. Nemeroff, who heavily promoted the benefits of GlaxoSmithKline drugs without revealing that he had received $800,000 from the drug maker.

Several states have recently passed laws requiring pharmaceutical companies to reveal what they pay to doctors. Lilly is the first to make its list public, revealing that it paid $22 million to 3,400 healthcare providers during the first quarter.

Besides Suarez-Barcelo and Cohen, the other top beneficiaries in South Florida were Michael A. Weitz, a South Miami rheumatologist who received $16,800; Guillermo Valenzuela, a Plantation rheumatologist, $14,000; and Raja Mudad, a Hollywood oncologist, $12,000.

Two University of Miami oncologists were also among the top beneficiaries: Luis E. Raez, $14,000, and Edgardo Santos, $10,500.

In most of the cases, the website -- Lillyfacultyregistry.com -- reported that the doctors had earned their fees by speaking at professional education seminars. A few received sums for educating patients or consulting.

In a telephone interview Friday, Suarez-Barcelo said he specializes in treating nursing home patients and he earned his money speaking to similar professionals about Forteo, ``the only drug approved in the United States to rebuild bone'' in patients with osteoporosis.

He said he is even-handed in his speeches, talking about the comparative benefits of other osteoporosis drugs and those cases in which Forteo is not indicated. Medical education in nursing home settings is ``pretty dismal,'' and he has provided a valuable service, he said.

Lilly has a cap of $75,000 a year in payments to healthcare providers, meaning Suarez-Barcelo won't be doing much more work for the company in 2009, the North Miami doctor said.

Suarez-Barcelo called attempts to limit drug makers paying doctors ``very short-sighted'' because it would result in less education. He said money from Lilly would not influence his choice of drugs for patients.

INCOME REPORTING

Laurence Gardner, the UM medical school's executive dean for education, said the institution has strict requirements about faculty reporting outside sources of income and there are limitations on what they can accept from pharmaceutical companies.

Gardner said fees paid for speaking engagements were permissible within UM's guidelines.

Santos, one of the UM oncology doctors, said Lilly had paid him for talking about Pemetrexed, a chemotherapy treatment.

He said his lecturers always stayed within the Food and Drug Administration guidelines for the drugs. He said Lilly's payments to him would ``absolutely not'' influence his decisions on what drugs to prescribe for his patients.

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