The recently-passed health care law includes a “sunshine” provision that seeks to root out conflicts of interest between doctors and drug companies.
As part of the package of health care rules that passed last week, pharmaceutical companies will have to disclose how much they pay doctors for various services. Individual physicians sometimes earn tens of thousands of dollars from a company, but the public has no way of getting the total of how much the industry is paying doctors.
The Sunshine provision in the health care law is intended to help root out potential conflicts of interest between doctors and pharmaceutical or medical device companies. Some doctors earn money from the industry through consulting, speaking engagements, and research. The concern is that this relationship can influence a doctor’s choice of medication.
Bioethicist Art Caplan says the requirement will help expose conflicts.
Caplan: We still have to ask a fundamental question, which is, are there certain relationships, even if disclosed, that shouldn’t exist, and are there certain relationships that involve the exchange of money with doctors that are reasonable business practices and you can disclose them but you wouldn’t say they’re a conflict of interest inherently.
Some physician groups are concerned that the disclosures — which include payments as little as $10 — may give the public the wrong impression. They say the disclosure rules make no distinction between appropriate and inappropriate relationships between doctors and companies.
Joseph Reichman, president of the Medical Society of New Jersey, says conflicts will be difficult to distinguish from above-bar relationships.
Reichman: There have been abuses in the past and significant dollars paid out and those things really have not been transparent to the public and they should be. But an individual reporting $10 and anything over $100 from a company over a year can be pretty onerous.
Pharmaceutical companies carry the burden of reporting payments, but they support the move toward transparency, and some have already begun posting payments to physicians on their website. Diane Bieri is the executive vice president and general counsel for the trade organization PhRMA.
Bieri: PhRMA has always indicated that we support transparency as long as it does not chill the important relationships between physicians and our companies. We think those relationships should continue. They do improve patient care.