The president of the National Kidney Foundation, which last year issued guidelines encouraging doctors to make aggressive use of Amgen's biologic drug Epogen to treat anemia, received at least $35,000 in consulting and speaking fees from Amgen in 2004-2005, according to the New York Times.

Moreover, Amgen contributed an additional $1.9 million in 2004 to research and education programs led by Dr. Alan Collins, a Minneapolis nephrologist, according to records examined by the newspaper.

The disclosures come as the government takes a hard new look at the overuse of biologic drugs known as Erythropoiesis Stimulating Agents. The FDA cautioned doctors earlier this month that over-prescribing ESAs can increase the risk of dangerous blood clots and early death in some patients.

The Times article on March 21st also coincides with a study published in the new issue of the Journal of the American Medical Association, which found that laws in two states requiring disclosure of pharmaceutical company payments to physicians do not provide easy or very useful access to that information.

In examining how the disclosure laws of Minnesota and Vermont functioned, the researchers said they found both incomplete disclosure by drug companies and loopholes that allow the hiding of millions of dollars in payments, and make it difficult to know which doctors are receiving them.

The payments involving Dr. Collins, for example, were uncovered by examining individual disclosure forms for the period 2002 through 2005 that had to be manually photocopied at Minnesota's State Board of Pharmacy.

In a subsequent email to the New York Times, the kidney specialist said he personally received less than $10,000 from Amgen in 2004.

“The contract amount of $1.9 million from Amgen was paid to the Minneapolis Medical Research Foundation (MMRF) for the research contract, on which I am the designated senior researcher,” Dr. Collins wrote.

But Amgen, according to the JAMA researchers, reported making zero payments to Minnesota doctors in 2004, after disclosing 529 payments totaling $4.02 million in 2003. (It also reported zero Minnesota payments in 2002.)

There is nothing illegal, as the Times points out, about doctors accepting money from pharmaceutical companies for consulting or making speeches. Doctors largely insist such payments do not influence their views on patient care.

“Just because I might do consulting work doesn’t mean I don’t press the agenda of the public health,” Dr. Collins said.

But some physicians are particularly concerned over large pharmaceutical company payments to doctors who are involved in establishing treatment guidelines.

Dr. Daniel Coyne, a physician at Washington University in St. Louis who has been publicly critical of the NKF guidelines recommending aggressive use of ESAs, said: "Amgen's funding for Dr. Collins' MMRF is another huge financial connection to individuals at the National Kidney Foundation.

"The [kidney] foundation's recent pro-industry anemia guidelines -- and the revisions due next month -- have to be viewed with great skepticism," Coyne added.