As we reported last year, part of the Obama administration’s health-care reform includes the Physician Payments Sunshine Act. It requires drug companies to disclose payments they make to doctors for research, consulting, speaking, travel and entertainment. Sometimes, such compensation influences treatment decisions and encourages overuse of drugs and devices. And these relationships are ripe for conflicts of interest.
So where are we in this process of finding out who’s getting what from whom?
According to the public interest news site ProPublica.org, things are moving slowly, but they’re moving. Final regulations were announced last month, but the release of payment data won’t happen until September 2014. The information was supposed to become public beginning this year, but since federal officials released the proposed regulations in December 2011, they’ve been collecting and analyzing comments about them.
Either there was a tsunami of comments, or the government is a bit tardy.
The first group of data to be released reflects payments made from August to December of this year. The reporting companies must turn the data over to the government by March 2014, then doctors have 45 days to review it for accuracy before it becomes public. Companies must report every year.
The information helps patients find out if their doctors receive money from any companies whose products they prescribe. If they do, these docs might be influenced to treat their patients in a way that might not be in the patients’ best interests.
Until now the only similar resource has been a ProPublica initiative, Dollars for Docs. It has tracked payments since 2009 from a dozen drug companies, most of which were required to post the information on their websites as part of lawsuit settlements with the federal government. Mostly, the companies allegedly engaged in illegal marketing practices, such as off-label promotion. That’s when they promote a drug or device for a treatment purpose for which it hasn’t been approved by the FDA. Such settlements total billions of dollars.
Soon, Dollars for Docs will be updated through 2012 and include payment info from 15 companies.
Everyone-drug companies, lawmakers and consumer advocates-has been frustrated with how long it has taken the Centers for Medicare and Medicaid Services (CMS) to release the final rules for collecting and publishing the data. But at least it’s happening.
Any payment larger than $10 made to a U.S. physician or teaching hospital must be reported by date of payment and include a description of the service provided, the amount paid and which company products the payment involved. Speaking fees, consulting payments, research, gifts, food, entertainment, honoraria, research grants, royalties and license fees are included.
Fines for failure to report range from $1,000 to $10,000 for each incidence. A deliberate failure to report can cost $1 million.
According to ProPublica, some practitioners are rolling in the payment (graft?) green.
One Los Angeles-area doctor got more than $300,000 in speaking fees in 2009 and 2010 alone just from the companies in its database. Those businesses account for less than half of all U.S. pharmaceutical sales, so who knows how much more dough is in promotional play?
It’s interesting-dismaying?-to note that more than 250 physicians who were drug company speakers and consultants had been disciplined by their state medical boards or other regulatory agencies.
Find out if your physician is one of them at the Dollars for Docs link.