Amgen Inc. and Johnson & Johnson are paying doctors hundreds of millions of dollars every year in return for prescribing anemia drugs which regulators now say may be unsafe at commonly used doses, the New York Times reported on its Web site on Wednesday.

The payments are legal, the Times said. But it cited critics as saying that the payments give doctors an incentive to prescribe the anemia drugs known as EPO at levels that might increase risks of heart attacks or strokes.

The paper said Amgen and Johnson & Johnson had not disclosed the total amount of payments to doctors, but it cited estimates from industry analysts that such payments total hundreds of millions of dollars a year.

Companies cannot pay doctors to prescribe drugs that are given in pill form and purchased from pharmacies, but they can rebate part of the price that doctors pay for medicines that they dispense in their offices, the Times said.

Johnson & Johnson and Amgen could not immediately be reached for comment.

But the Times quoted Johnson & Johnson as saying that its rebates were not intended to induce doctors to use more medicine, and instead "reflect intense competition."

Amgen told the paper that the rebates were a normal practice and that it had always properly promoted its drugs.

"Amgen is dedicated to patient safety," the paper quoted a spokesman as saying. "We believe our contracts support appropriate anemia management and our product promotion is always strictly within the label."

The Times also cited analysts as saying that DaVita, the biggest owner of dialysis clinics in the United States, gets a quarter of its revenue from anemia drugs.

DaVita could not immediately be reached for comment.

The paper quoted David Van Wyck, senior associate to the chief medical officer of DaVita, as saying the company did not overuse the medicines.

Doctors determine how much to use, the Times quoted Van Wyck as saying. "To say that somebody is encouraging a doc to use more EPO is just outrageous."

(Published by Reuters, May 9, 2007)