Friday, March 21, 2008

Reporting Gifts to Physicians -- on this I Agree

There's now a Senate and House of Representatives version of the "Physician Payment Sunshine Act," which would require pharmaceutical companies to post in electronic format (ie, Web site) every gift or payment over $25 made to a physician (and name, address, etc. of the physician). Not just gifts given directly by drug reps, but also "through an agent, subsidiary, or other third party" and not just directly to physicians, but also "an entity that a physician is employed by, has tenure with, or has a significant ownership interest in; or to a covered organization in which a physician has a significant professional membership interest..."

This "sunshine" bill also has a few dark clouds associated with it.

I have to agree with Bob Ehrlich of DTC Perspectives that "this bill seems overly onerous" and "is meant to discourage payments to doctors by outing them and the drug company on a public site."

Bob also said:
"I would support public disclosure of payments of significance such as for speaking to other physicians on a drug company's behalf. I would also support disclosure of free trips to symposia or other influence peddling events such as Super Bowl trips. Clearly reporting large payments is useful in public understanding of how drug companies influence doctors."
Do I agree with this? I hate to sound like a Clinton, but it all depends on what "large" means. Is "large" more than $100? This is the cutoff amount specified in PhRMA's voluntary guidelines on gifts to physicians. Usually, these types of bills attempt to codify such voluntary guidelines and I'm not sure where the $25 limit came from other than the idea of setting the bar so low that it would put the pharma "tchochke" industry out of business!

Industry-sponsored CME Also In This Bill's Sights
The bill would also require reporting of payments made to physicians for "participation in a medical conference, continuing medical education, other educational or informational program or seminar, or funded research (such as lab-based, epidemiology, or health services research) that is not a clinical trial; provision of materials related to such a conference, educational or informational program or seminar, or research; or remuneration for promoting or participating in such a conference, educational or informational program or seminar, or research;"

Survey Results
Pharma Marketing News, which I publish, did a survey of readers in 2006 asking their opinions on whether or not the following gifts to physicians create conflicts of interest:

* Free drug samples
* Free meals away from the office
* Pharma-supported CME (free to physicians)
* Payment for consulting relationships
* Payment for travel to meetings or scholarships to attend meetings
* Payment for participation in speakers bureaus
* Free provision of ghostwriting services
* Grants for research projects
* Payment for attendance at lectures and conferences
* Free lunch delivered to office in exchange for sales presentation

You can review an interactive summary of the results (de-identified, excludes open-ended responses and comments that may identify the respondent) here.

For a complete in-depth analysis with comments from Pharma Marketing Roundtable participants, see the article "Free Gifts to Physicians: What's the Big Deal?" published in the February, 2006 issue of Pharma Marketing News (subscription or reprint fee required to access the full text of this article).

1 comment:

  1. Anonymous9:21 AM

    Many US state government offices (and maybe Federal) restrict vendor gifts to their employees to under $25. The number might have come from these policies. I don't think the two situations are equivalent -- I suspect that not much thought was given to the particular number.


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