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Government to Release Drug Company Payouts to Doctors

drug compnay payoutsBased on possible ethical conflicts specific to medicine, data on drug company payouts to tens of thousands of individual doctors is being revealed by the Obama administration.

The conception of the “Open Payments” program, as initially designed, was to make it easier for patients to look up their own doctors online. That particular functionality is not yet available and preliminary data to be released on Tuesday will not be complete although experts anticipate it will be highly beneficial for professional researchers.

Under the new healthcare law, manufacturers are mandated to report payments, as well as gifts to doctors, excluding those valued at $10 or less. Under President Obama’s administration, the program, which has support from both republican and democratic lawmakers, is to open the books of the medical profession. Medicare’s huge claims database was released a few months ago, which for 2012, showed over 825,000 medical providers having received program payments.

Traditionally, drug companies have coveted relationships with doctors who are ultimately the gatekeepers between patients and prescription medications. However, a built-in conflict of interest with risk of influencing decisions regarding prescriptions has been identified by consumer groups.

As such, a number of physicians’ offices have started to cut back on pharmaceutical marketing, to include receiving even small items such as coffee mugs, pizzas, and pens, to more elaborate and paid events like golf outings, lavish resort stays, and speaking engagements. However, there are still a large number of doctors who receive sizeable payments as a means of helping drug companies in conducting clinical research.

According to ProPublica, an investigative journalism website, approximately 3.4 million payments to healthcare professionals since 2009 have been tracked. Together, these marketing “items” total over $4 billion, more than 50% the amount spent on medical research.

In light of this information, the American Medical Association (AMA) has serious concerns about the payments file being released. A representative from the AMA adds that there could be inaccuracies in the data, as well as context that would make it difficult for the average person to evaluate.

Based on AMA’s concerns, individual doctors will be offered a chance to inspect their data prior to release, this according to the federal Centers for Medicare and Medicaid. Even with this, the AMA says the amount of time provided to doctors to conduct this examination and the process itself, are extremely cumbersome.

Consumer groups that call this disclosure program the “Sunshine Act”, agree it is way overdue. John Santa, medical director for health projects with Consumers Union stated that time and time again, research has shown financial relationships influence doctors, even if it is nothing more than going out for dinner.

Multiple studies on the subject have been conducted and while most medical professionals believe that financial relationships have an effect on doctors, they do not feel it has an impact on “them” personally.

According to Robert Wah, President of AMA, when it comes to research, there are some financial dealings between healthcare professionals and the drug industry that are beneficial but at the same time, there are inappropriate relationships that often drive innovation pertaining to patient care.

In the information being released are payments by medical device and drug manufacturers to doctors, dentists, optometrists, podiatrists, chiropractors, and teaching hospitals. The data will also reveal ownership stakes by doctors as far as group purchasing organizations that buy devices and drugs for a much wider community.

In the initial release, it is hard to tell just how many medical professionals are included but the Obama administration estimates that 50% of the 897,000 covered in the data still have transactions needing to be reported. Of those, roughly 224,000 have interest in reviewing the data, which to some indicates substantial financial payments received.

Senator Charles Grassley, Republican from the state of Iowa, supported the provision for disclosure, saying that he hopes the data over time will be used as a consumer resource.

From this, patients prescribed beneficial yet risky drugs, will have the opportunity to learn if a prescribing doctor accepted money from the drug company as a means of studying potential risks opposed to personal gain. Even if nothing changes, he feels that patients have the right to know.

There are also concerns that the released data will discourage medical professionals from participating in sponsored research being conducted by drug companies.

Mary Grealy, president of the Healthcare Leadership Council said her biggest worry is that medical professionals, as well as hospitals and drug companies will no longer be interested in having their names associated with payments, even when being used for the right reasons. Grealy also feels the $10 reporting threshold should be increased and that for research, there needs to be more context on payments.

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