One of the less-noticed provisions of the Affordable Care Act is a requirement that pharmaceutical companies report to the Department of Health and Human Services the gifts and other payments they give to doctors and teaching hospitals -- and that HHS in turn make that information available to the public. (It's sometimes referred to as the "Physician Payment Sunshine Act," after legislation previously introduced in Congress by Senator Chuck Grassley.) Earlier this month, HHS released its final regulations to implement this provision. Beginning August 1, 2013, drug and device companies will need to track their payments to doctors and hospitals, and submit reports to HHS by March 31, 2014 (and report annually thereafter). HHS will make the information available to the public starting in September 2014.
ProPublica's Charles Ornstein and Tracy Weber, who've been reporting on the pharmaceutical-marketing issue for years, summarize the HHS requirements:
Drug, device and medical supply companies must report all payments over $10 to U.S. physicians and teaching hospitals. The data must include date of payment, a description of the service provided, the amount paid and which of a company's products the payment involved.
The types of payments to be reported include speaking fees, consulting payments, research, gifts, food, entertainment, honoraria, research grants, royalties and license fees, among others.
Companies that fail to properly report payments can be fined between $1,000 and $10,000 for each payment not reported, but the fine cannot exceed $150,000. A deliberate failure to report can lead to a fine of up to $1 million.
I'd certainly like to know if my doctor were receiving payments from a pharmaceutical company, especially if the doctor were recommending a drug manufactured by a company that had been buying her dinner or paying her to speak at meetings. Getting gifts from a drug company doesn't necessarily equate to bad prescribing, but having positive feelings for a company might make a prescriber a little more likely to prescribe Drug A when Drug B is cheaper or has fewer side effects -- or when a non-pharmaceutical treatment might be the best option for some patients.
For several years, ProPublica's Dollars for Docs database has been the best publicly available source of information about drug-company payments to physicians nationwide. It contains information on payments made by 12 drug companies who make doctor-payment information available online, usually because they're required by a legal settlement to do so. (The companies include Eli Lilly, Johnson & Johnson, Merck, and Pfizer, who are among the top-revenue pharma companies.) ProPublica combines the info from these companies and makes it searchable by state and by doctor -- so, you can browse payments made to doctors and institutions in your state, or see how much your doctor received from pharmaceutical companies.
The Hill's Elise Viebeck reports that a survey by tech firm MMIS Inc. finds that more than half of doctors are unaware of the law's provision on physician payment reporting. For some doctors, learning that their payments from drug and device companies will be publicly reported might cause them to rethink whether they really want to eat so many free dinners or accept so many speaking fees from manufacturers.