Move is part of effort to open the books of the medical profession
By Ricardo Alonso-Zaldivar
Associated Press
WASHINGTON (AP) - Striving to shine a light on potential ethical conflicts in medicine, the Obama administration is releasing data on drug company payments to tens of thousands of individual doctors.
As conceived, the so-called Open Payments program was intended to allow patients to easily look up their own doctors online. That functionality won't be ready yet. And although preliminary data to be released Tuesday will be incomplete, it's expected to be useful for professional researchers.
President Barack Obama's health care law requires manufacturers to report payments and gifts to physicians, unless they are valued at less than $10. It's part of a shift under his administration, supported by lawmakers of both parties, to open the books of the medical profession. A few months ago Medicare released its massive claims database, showing program payments to more than 825,000 providers for 2012.
Drug companies traditionally have prized their relationships with doctors, the gatekeepers between patients and prescription medications. But consumer groups see a built-in conflict of interest that could influence prescribing decisions.
Some doctors' offices have started curbing pharmaceutical marketing, which can include anything from free pens and pizzas to paid speaking engagements and golf outings at fancy resorts. But many doctors also receive significant payments to help drug companies conduct clinical research.
The investigative journalism website ProPublica says it has tracked 3.4 million payments to health professionals since 2009 totaling more than $4 billion. More than half that amount was for research.
The American Medical Association says it is "extremely concerned" about release of the payments file, adding that the data may contain inaccuracies and lacks context to help the average person evaluate the information. The federal Centers for Medicare and Medicaid Services provided individual doctors an opportunity to inspect their data prior to release, but the AMA says the window was short and the process cumbersome.
Consumer groups call the disclosure program the "Sunshine Act," and say it's overdue.
"Research has shown over and over that these financial relationships influence doctors, even a meal," said John Santa, medical director for health projects with Consumers Union. "Studies also show that doctors believe it does not affect them, but strongly believe it affects other doctors."
AMA President Robert Wah said in a statement that some financial dealings between doctors and the drug industry help patients, particularly when it comes to research. There are "appropriate relationships in this realm that can help drive innovation in patient care," Wah said.
The information being released Tuesday covers payments by drug and medical device manufacturers to doctors and teaching hospitals. Also to be reported are doctors' ownership stakes in "group purchasing organizations" that buy drugs and devices for a broader community.
The program covers doctors, dentists, podiatrists, optometrists and chiropractors.
It's unclear how many clinicians will be included in the initial release. The administration has estimated that about half of the 897,700 medical professionals potentially covered have industry transactions that must be reported. Of those, it estimated about 224,000 would want to review their reports - indicating significant financial payments.
The disclosure provision was championed in Congress by Sen. Charles Grassley, R-Iowa, who said Monday that he hopes the data will become a resource for consumers over time.
"The patient who is prescribed a drug that might be beneficial yet risky will be able to learn whether the prescribing doctor accepted drug company money to study the risks." Grassley said in a statement. "The information might not change the outcome, but it's something a patient might like to know."
Others worry it will discourage doctors from participating in research sponsored by drug companies.
"My biggest concern is it will have a chilling effect and physicians will say 'I don't want to see my name on a list,'" said Mary Grealy, president of the Healthcare Leadership Council, an umbrella group that includes doctors, hospitals and drug companies. She would like to see the $10 reporting threshold increased, and more context on payments for research.
Published: Wed, Oct 01, 2014
