With apologies to the late songwriter John Denver, will doctors be happy if their ties with drug companies are exposed to sunshine?
If Senators Chuck Grassley (R-IA), and Herb Kohl (D-WI) have their way, it won't matter - disclosure will be required by law.
Medical Marketing & Media news reports that the senators have re-introduced the Physician Payments Sunshine Act. The bill would require companies to disclose payments or transfers of value to physicians of $100 or more. The bill is similar to a bill they introduced in the last Congress, but this time, it has more hefty enforcement penalties.
According to the article, "beginning in April, 2011, companies would be required to report payments and other transfers of value for: consulting fees; compensation for other services; honoraria; gifts; entertainment; food; travel; education; research; charitable contributions; royalty or license fees; current or prospective ownership or investment interests; CME speaker fees and grants, along with anything else the HHS secretary deems necessary. Where payments are related to marketing, education or research specific to a covered drug, device, biological or medical supply, the company would be required to furnish that information, including the name of the therapy.
Manufacturers or group purchasing organizations that fail to report payments can be fined between $1,000 and $10,000 per infraction, up to a total fine of $150,000 per company per year, where failure to report is deemed an oversight. For 'knowing failure to report,' the ceiling on total fines goes up to $1 million per company."
ACP has not yet analyzed the bill nor determined our position on it. Last year, we declined to take a position on the bill, based in large part on the advice of our Ethics, Professionalism and Human Rights Committee. Some members of the committee felt that a mandatory disclosure requirement would actually undermine professionalism, because it could send a signal that acceptance of gifts are okay as long as they are disclosed (by someone other than the physician, in this case) or fall below the $100 threshold. (ACP policy on physician-industry relations says that "the acceptance by a physician of gifts, hospitality, trips, and subsidies of all types from the health care industry that might diminish, or appear to others to diminish, the objectivity of professional judgment is strongly discouraged.")
With the focus in Washington on "transparency" it is likely that some version of the Grassley/Kohl bill could become law. The sense is that the public is served when potential conflicts are exposed to sunshine, whether it applies to lobbyists' contacts with federal officials, freedom of information requests to federal agencies, or doctors' financial ties to pharma.
Today's questions: Do you think companies should be required to disclose contributions of $100 or more of value to doctors, including gifts, consultant fees, honoraria, education, research, and charitable contributions? What impact do you think this will have on medical education, research, or other potentially beneficial arrangements?