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Law casts "sunshine" on physician-industry relationships

In the interest of transparency, pharmaceutical and medical device manufacturers will start to gather information about any payments they make to doctors and teaching hospitals, beginning Aug. 1. The results will be available online next year in a massive, national online database being managed by the federal government.

The so-called Sunshine Act was passed by Congress as an amendment to the Affordable Care Act. The thinking is that consumers will make more informed decisions about their care if they know their doctors received certain kinds of payments, including consulting fees, gifts, stock options or reimbursements for travel and education, from a commercial enterprise.

But there is enormous room for error in the undertaking, as the law is complicated and there is a vast quantity of data involved. For instance, there is concern about how companies will report payments for research, which could be misleading. As Harry Greenberg, MD, senior associate dean for research at Stanford, told me for an Inside Stanford Medicine article:

I am hopeful that the specific purpose for the payments will be clear and accurate in the public database. For instance, the law requires companies to report payments for specific research projects, which would be totally appropriate and important. Such payments, of course, actually are made to Stanford University not the individual principal investigator. The university then uses them to fund specific research projects. It also includes reporting of payments for participation in speakers’ bureaus, which is something not permitted at the medical school. I hope the database makes the reasons for specific payments clear and that the companies will report them accurately. But there is potential, given the massive amount of complex data, that there will be errors.

There has much speculation on the potential impact of the law. For instance, will consumers change their behavior – say, choose a different physician - based on what they learn from the reports? Or will doctors modify their own behavior by changing their drug-prescribing habits or steering away from industry connections altogether, to avoid the appearance of any potential conflicts of interest? All that remains to be seen, once the public records go online in September 2014.

Previously: Many physicians unaware of gift-disclosure law, shows survey, The NIH gets tough on conflicts of interest, Stanford’s medical school expands its policy to limit industry
, Faculty consulting work: now on public view and Let the sun shine: Legislation would publicly disclose physician-industry relationships

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