Disclosure of Pharmaceutical Payments to Physicians
Poor data, little disclosure
One approach to addressing potential conflicts of interest among physicians receiving payments from pharmaceutical companies is to require disclosure of such payments through publicly accessible records. Five states and the District of Columbia have laws mandating public disclosure. To assess the adequacy of such laws in Vermont and Minnesota, physician-specific payment records were obtained for a 3-year period from each state (in the case of Vermont, after considerable negotiation with the state attorney general).
Access to data, and the format of the available data, were considered by the authors to be restrictive and cumbersome, with significant disorganization and gaps due to payments being labeled as "trade secrets" by pharmaceutical companies, the need for lawsuits to force disclosure, the need for photocopying of paper records (some handwritten), a lack of physician-specific data, and poor definitions of payment type (e.g., cash, check, honoraria) and purpose (e.g., consulting, education, marketing, speaking). Only 15 of 60 pharmaceutical companies making disclosures in Minnesota disclosed complete data for all 3 years. Physician-specific analyses could not be made in Vermont. In Minnesota, roughly 7000 distinct physician payments of $100 or more were made (median amount, $1000).
Comment: The importance of this study lies not only in the actual results, but also in its revelation of how inadequate the systems are for disclosing even the most basic of pharmaceutical payment data, and of how inadequate the data are to help patients understand how physicians might be influenced by such payments.
Thomas L. Schwenk, MD
Published in Journal Watch General Medicine March 20, 2007
Ross JS et al. Pharmaceutical company payments to physicians: Early experiences with disclosure laws in Vermont and Minnesota. JAMA 2007 Mar 21; 297:1216-23.
- Medline abstract (Free)
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