Drug firms release payment information

Excerpted from “Drug and device firms paid $3.5B to care providers,” Associated Press. September 30, 2014 — Drug and medical device companies paid doctors and leading hospitals billions of dollars last year, the government disclosed Tuesday in a new effort to spotlight potential ethical conflicts in medicine. The value of industry payments and other financial benefits totaled nearly $3.5 billion in the five-month period from August through December 2013, according to the Centers for Medicare and Medicaid Services, which released the data.

It's part of a new initiative called Open Payments, required by President Barack Obama's healthcare law. It was intended to allow patients to easily look up their own doctors online, but that functionality isn't fully developed. In future years, the information will cover a full 12 months and will be easier to search, officials said.

Consumer groups said it's a step toward much-needed transparency. But doctors and industry said the government rushed to release the data, and they raised questions about accuracy and lack of context.

The American Medical Association said it remains "very 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. Consumer groups say disclosure is 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."

Commentary

CMDA Member John Dunlop, MD: “Wow! $3.58 billion spent by pharmaceutical and device manufactures to directly influence physician choice is an impressive amount. I naively thought that these payments and gifts went out with the free lunches and logos on pens several years ago. It appears that those restrictions do not have much substance and thus the potential for ethical abuse persists as a real threat. The number comes from the website “Open Payments,” a project of Obamacare intended to bring accountability to the heretofore undisclosed inducements given by industry to practicing physicians. It should be noted, however, that just two days after this article was released, another article pointed out many potential flaws in this data.

“As Christians, when faced with the possibility of receiving incentives from industry, we must remind ourselves that our primary responsibility is not to make money but to provide the best, compassionate and cost effective care to our patients. In Proverbs 19:6, Scripture warns that receiving gifts influences our behavior, and this may be true even when those gifts do not obligate the recipient to prescribe the products involved.

“The CMDA Ethics Statement on Doctor & Pharmaceutical/Medical Device Industry Relationships states the ethical principle: ‘Doctors should consider carefully the basis of their therapeutic decisions to assure that they are made in accordance with best possible evidence applied to the welfare of the patient. Personal gain must never be the compelling reason for our decisions. Incentives from industry, intended to influence therapeutic choices, can compromise doctor integrity and behavior.’”

Resources

Christian Physician’s Oath
Doctor & Pharmaceutical/Medical Device Industry Relationships Ethics Statement
Professionalism in Peril - Part 3: Professional Adultery