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Feds to Publicize Drug and Device Company Payments to Doctors Next Year

After a long delay, the U.S. Centers for Medicare and Medicaid Services published final rules for the Physician Payments Sunshine Act, which would bring transparency to financial relationships between physicians and industry.

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(Mychele Daniau/AFP/Getty Images)

Update, Feb. 1, 2013: This story has been updated.

After years of anticipation, all of the nation's drug and medical device makers must soon begin publicly reporting payments they make to U.S. physicians, according to final regulations announced this afternoon by the federal government.

The release of payments data in September 2014 would mark a milestone in the push to bring transparency to medicine. Once posted, patients will be able to see if their physicians receive money from any of the companies whose products they prescribe. Studies have shown that such payments, however small, bias physicians towards companies and their products.

Until now, ProPublica's Dollars for Docs tool has been the only freely available source for the public to search and analyze the payments made since 2009 by a dozen drug companies. ProPublica gathered the information from the companies' websites into one searchable, sortable database.

Most of these companies were required to post the information on their websites as part of settlements with the federal government over allegations of improper marketing. Companies have paid billions of dollars to settle the lawsuits.

ProPublica is working on an update of Dollars for Docs and in the coming weeks will expand the database to include payments from 15 companies through the end of 2012.

Drug companies, lawmakers and consumer advocates have grown increasingly frustrated by the time it has taken the U.S. Centers for Medicare and Medicaid Services (CMS) to release final rules for collecting and publishing the data under the Physician Payments Sunshine Act, which was a part of the 2010 health reform law.

The payments were supposed to become public beginning this year under provisions of the law. But federal health officials instead released proposed regulations in December 2011 and since then have been gathering and analyzing comments.

The data to be released in September 2014 will include payments made from August to December of this year, giving companies enough time to gather and report the information. The companies must turn the data over to the government by March 2014; doctors will then have 45 days to review the information for accuracy before it becomes public.

Companies will have to report the information annually afterward.

"You should know when your doctor has a financial relationship with the companies that manufacture or supply the medicines or medical devices you may need," Dr. Peter Budetti, the CMS deputy administrator for program integrity, said in a written statement. "Disclosure of these relationships allows patients to have more informed discussions with their doctors."

Sen. Chuck Grassley, R-Iowa, co-authored the Sunshine Act, which arose from his investigations of drug company payments to doctors. "Disclosure brings about accountability, and accountability will strengthen the credibility of medical research, the marketing of ideas and, ultimately, the practice of medicine," he said in a statement. "I will stay vigilant about how this law is implemented, especially after the delays seen already."

The drug companies that currently post payment information do so in different ways, using different time periods and different definitions that make analysis or aggregation of the data very difficult. The Physician Payments Sunshine Act requires every company to report the same information in the same way.

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.

The trade group representing major pharmaceutical companies said it is reviewing the regulations. It had raised a number of concerns to the government. The Pharmaceutical Research and Manufacturers of America "remains committed to the principles of the Sunshine Act" and wants the information to be "usable, transparent, and understandable," Matthew Bennett, the group's senior vice president, said in a statement.

ProPublica's analysis of the payments released so far shows that many physicians receive money from several companies for promotional speaking or consulting on behalf of their products. In some cases, these payments totaled hundreds of thousands of dollars.

One Los Angeles-area doctor, for example, received more than $300,000 in speaking fees in 2009 and 2010 alone just from the companies in our database. Those firms account for only about 40 percent of U.S. pharmaceutical sales.

ProPublica also found that more than 250 physicians chosen to be drug company speakers and consultants had been disciplined by their state medical boards or other regulatory agencies.

abinico warez

Feb. 4, 2013, 5:55 p.m.

And how will this reduce the 200,000 yearly deaths by medical mistake?

Appreciate your reporting on this issue. I can understand teaching and research hospitals working with clinical trials but beyond that doctors in private practice working on behalf of pharma’s is not, in my opinion, ethical.

Nothing will happen UNLESS we as a nation get off our dead asses and concentrate on being what we were intended to be: actively involved and well-informed citizens. Until we do, we have NO legitimate complaints.

If the information will be on the internet, very few will find it or seek it out. Especially the elderly who are not computer versed. They need to require the information be posted clearly on the wall of the waiting room AND the Hospital Lobby where the doctor works.

David Phillip

Feb. 4, 2013, 11:49 p.m.

Bid Pharma has and will continue to spend millions to not only market their products and “condition” the medical profession, but also on circumvention and obfuscation on their methodology and questionable practices. Through lobby they basically “direct” the FDA.

Stephanie Palmer

Feb. 5, 2013, 7:47 a.m.

I look forward to this, but I don’t buy my prescriptions in this country. Drugs are ridiculously cheaper in Canada. I have no idea why the voters accept it, but there you are. Suckers all.

Sal, don’t forget that, if the information isn’t public, it’s impossible to be well-informed unless you’re on the inside.  So making this information public is a good first step.  The next hurdle will be convincing people to look at it…

Thanks, ProPublica, for being what and who you are, since it takes people like you, keeping us informed and others warned - to help make our “system” (not just healthcare) set up safeguards against corruption. It’s an endless task.

Deborah Thaler

Feb. 10, 2013, 6:31 p.m.

How about investigating prosecutorial misconduct against innocent physicians!!!!!!!!! My husband is about to start a 10 month prison sentence when no law was broken. Federal Prosecutors bullied my husband and threatened to “put him away for years”. They had no evidence, but they terrorized and threatened him into making a plea deal. How great is that. They did not have to prove a thing, as there was nothing to prove, do no real investigation, and my husband, with a sterling 30 year career as a successful Internist, gets to go to Federal Prison, for NOTHING! investigate that!

Deborah Thaler. Was this the case that involved your husband? (See below published at https://oig.hhs.gov/fraud/enforcement/criminal)

If so, please explain why he was arrested if no law was broken. (I am a journalist) If you feel that there has been misconduct by Federal authorities, you should obviously report it.

December 18, 2012; U.S. Attorney; Central District of California
Orange County Doctor Sentenced to Year in Prison in $11 Million Medicare Scam Involving Patients Recruited from L.A.‘s ‘Skid Row’
LOS ANGELES - A physician who admitted homeless patients to the Tustin Hospital and Medical Center after they had been driven from “Skid Row” in downtown Los Angeles as part of a Medicare fraud scheme has been sentenced to one year in federal prison. Dr. Kenneth Thaler, 61, of Westminster, was sentenced yesterday afternoon by Chief United States District Judge George H. King. Thaler, who admitted approximately 60 patients per month-including some who did not require hospitalization-also was ordered to pay approximately $11 million in restitution to the Medicare program.

Transparency in health care is extremely important.  But transparency in government is far more important for the country’s survival. 

As long as the large faux-news organizations are tolerated by our citizens, we have the distinct possibility of being controlled by masters of deceit and outright lies.  And the mass media outlets will be complicit in our demise.

Neil, I fail to see how picking on Fox is going to change that.  All major media are bought and paid for…
I’ve yet to meet a journalist who states, “I just want to report the news”.  It’s always about “making a difference”, which is just a nice way of stating, I want people to get the news from my point of view or beliefs…
If you need any further proof of that, try asking yourself how many stations report that those mass shooters are hooked on FDA approved drugs…  The answer is none, because the big boys at the tops of those news organizations know that once they start doing that, you’ll quit tuning in to them…

Are there significant loopholes in the disclosure requirements? I’ve just been checking on ten doctors all listed together as science advisors for a non-profit having enormous pharma significance. Five received more than a quarter million (combined) in two years, but two, who worked for industry, plus the Stanford, Harvard and Yale doctors received nothing according to propublica. The two who already work for industry probably don’t have to report, but it seems really odd that the big three university reps would get zero.

This article is part of an ongoing investigation:
Dollars for Doctors

Dollars for Doctors: How Industry Money Reaches Physicians

ProPublica is tracking the financial ties between doctors and medical companies.

The Story So Far

ProPublica is investigating the financial ties between the medical community and the drug and device industry. In October 2010, ProPublica compiled the list of payments that drug companies make to physicians and built a publicly searchable database so that patients could look up their doctors.

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