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Opinion
''Disclosure can address doctors' conflicts of interest''
"Eighty-four percent of American physicians have a financial relationship with a drug or medical-device company, according to the Archives of Internal Medicine. For more than a year, I was one of them.
When I was a psychiatrist in private practice, a drug company asked me to educate physicians about the benefits of its antidepressant. I was paid up to $750 a session for my efforts.
As a result, I saw firsthand how a simple exchange of money could undermine the objectivity of a well-meaning doctor. I oversold the scientifically demonstrated benefits of the drug and downplayed its equally well established disadvantages, rationalizing my behavior all along.
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Two years ago, Congress passed the Physician Payments Sunshine Act as part of the health-care reform law, requiring drug and device companies to disclose financial relationships with physicians and teaching hospitals. Once the provision is fully implemented, patients will be able to look up their doctors online and find out how much money they've received from the businesses whose products they prescribe.
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Unfortunately, the Obama administration has fallen at least a year behind schedule in its efforts to put the provision into effect. Last year, the Pew Health Group, Consumers Union, and Community Catalyst joined forces with leading drug and device industry associations to urge the Department of Health and Human Services to implement the legislation swiftly, noting that it will "protect patients and help restore trust in our health-care system." With such broad support for the program, there's no good reason for further delay."
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"The legislation requiring public disclosure of the financial relationships between healthcare vendors and physicians has been widely discussed in policy circles for years. Critics claimed payments for speaking, consulting, research or even the small trinkets and meals delivered during routine sales calls unduly influenced physician choices and inflated healthcare costs. To combat those effects, Congress required public reporting of those payments in a publicly accessible database. The legislation, labeled the Physician Payment Sunshine Act, was included in the 2010 healthcare reform law."
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Prescription project director Danny Carlat identifies issues with the Physician Payments Sunshine Act requiring further clarification and guidance. Addressing those would ensure that manufacturers can appropriately implement the final rule, and enable consumers to benefit from transparency reports published by the Centers for Medicare & Medicaid Services.
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The Pew Charitable Trusts is working to decrease the influence of pharmaceutical marketing on doctors’ practices. With a three-year grant from the Attorney General Consumer and Prescriber Education Grant Program, Pew is collaborating several partners to improve conflict-of-interest policies within the 158 medical schools and 400 major teaching hospitals in the United States.
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The Pew Charitable Trusts appreciates this opportunity to submit comments to CMS's "Information Collection Activities" draft guidance. We suggest that both the research and non-research payment templates be modified in order to make it easier for consumers to identify which drugs, devices, biologicals, or medical supplies are associated with particular transfers of value.
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On Feb. 1, 2013, the Centers for Medicare & Medicaid Services published the final rule guiding implementation of the Physician Payments Sunshine Act, which Congress passed as part of the Affordable Care Act in March 2010 to increase transparency in the relationships between physicians and drug and medical device makers. Here are some of the highlights.
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"The Obama administration issued a new rule this month that requires the makers of prescription drugs and other medical products to disclose what they pay doctors for various purposes, like consulting or speaking on behalf of the manufacturer. This overdue rule adds much-needed weight to previous, more limited disclosure requirements."
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Allan Coukell, director of medical programs for The Pew Charitable Trusts, issued the following statement in response to the Centers for Medicare & Medicaid Services' final rule for implementing the Physician Payments Sunshine Act, which will bring transparency to the financial relationships between physicians and drug and medical device companies.
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In 2011, the pharmaceutical industry spent nearly $29 billion on drug promotion — more than $25 billion on marketing directly to physicians and almost $4 billion on advertising directly to consumers (mainly through television commercials). This multi-pronged approach is designed to promote its products by influencing doctors’ prescribing practices.
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The Pew Health Group and Medtronic, Inc. file a joint letter to the U.S. Department of Health and Human Services urging implementation of the Physician Payments Sunshine Provision, which will require that manufacturers of drugs, devices,biologics or medical supplies report to the agency payments made to physicians and teaching hospitals.
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"Harmonizing conflict-of-interest standards will depend on the Centers for Medicare & Medicaid Services moving forward to implement the federal Sunshine law, which is now more than a year behind schedule. Industry, consumers and academic stakeholders are all waiting on CMS to issue a final rule."
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Nearly nine in 10 Americans recognize that antibiotics are effective treatments for fighting bacterial infections like strep throat, but more than a third mistakenly believe the drugs are also appropriate treatments for viral infections such as the common cold. Test your antibiotics IQ and take the quiz.
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During a session at the American Psychiatric Association's annual meeting on conflicts of interest, experts delved into the link between psychiatry and the pharmaceutical industry. While several speakers at the session pointed out that other specialties are similarly entangled with industry, "everyone does it" is generally not a valid defense where conflicts of interest are concerned.
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"Representatives from the FDA and industry expressed serious concerns about the potential impact of sequestration Monday, saying it's not a good time to shortchange the agency when it's under so much pressure to help bring innovative new drugs to market."
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"Forty-nine states, including Maine, now operate a prescription monitoring program - or are putting one in place - to track the powerful pain medication dispensed by pharmacies. These databases have already helped in the fight to curtail diversion and abuse of prescribed opioids. But the way they operate - and how the data they collect gets used - varies widely from state to state."
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Dr. Daniel Carlat, Director of the Pew Prescription Project, appeared before the U.S. Senate Special Committee on Aging to testify about the importance of implementing the Physician Payments Sunshine Act as quickly as possible.
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