With all the attention to the rollout of the Affordable Care Act -- and in particular, the glitchy federal health exchange website -- one element has gotten much less airtime until now: The Physician Payment Sunshine Act, which requires public disclosure of all pharmaceutical and medical device manufacturers’ payments to doctors. Senior reporter Charles Ornstein joins Managing Editor Robin Fields in the Storage Closet Studio this week to talk about the release of the first cache of data under the act, due in late September and covering payments made from August to December 2013.
The government’s website is in some ways the administration’s version of ProPublica’s Dollars for Docs news app, launched in 2010. ProPublica’s app, the first to publicly aggregate and disclose this kind of data, relied on a cache from just a handful of drug companies that began posting payments as part of lawsuit settlements.
Until now, Ornstein says, the picture has been limited. “While these are big companies that represent a good slice of the U.S. drug market, we haven’t been able to see what smaller companies have been up to; we haven’t been able to see what some of the device manufacturers have been up to. And I’m really curious to see if some of these smaller companies are making big, outsize payments to doctors that we just don’t know about.”
As Ornstein reported today, federal officials have temporarily taken offline the new system for doctors to verify payments from drug companies after at least one doctor had payments attributed to him that actually went to someone else.
Setting aside potential errors, doctors and manufacturers alike have expressed concern that there’s not enough context for the public to understand the relationships behind the payments. Of course, “the context that they’re looking for,” Ornstein says, “is statements from the government that relationships between drug companies and doctors are beneficial to the public.”
What should patients be looking for? “In the end, we’re all patients,” Fields points out.
If you find that your doctor is working for, say, the company that makes the cholesterol-lowering drug he’s prescribing, it’s worth asking about cheaper medicines or even a non-drug alternative, Ornstein says. “That’s a good idea either way,” he says, “but especially if your doctor’s received a payment, to ask these sorts of questions in a non-confrontational way is a good thing.”
Meanwhile, the specter of more transparency has both big pharma and doctors rethinking these payments. “We’ve heard that over and over again, that doctors are sort of skittish about their names being available in Google as receiving a payment from a drug company,” Ornstein says.
In the end, Ornstein thinks the release of the data can mean only good things for patients. “I don’t think this is going to be dangerous,” as detractors have claimed, he says. “I think this is going to be really helpful to the public, and in a few years, it will be built into, sort of, how we make medical decisions.”