'Sunshine-ing' on Docs Signals End to Pharma Largesse

WASHINGTON -- There aren't many gifts physicians can take from drug companies after this week without it becoming publicly reported.

Maybe a low-cost breakfast or midday snack and coffee. The little knick-knacks given out at exhibit booths. (Drug companies don't give office supplies like pens and note pads any more.)

Starting Thursday, drug and device manufacturers and group purchasing organizations must report payments or gifts in excess of $10 made to physicians in a yearly basis under the Physician Payments Sunshine Act. Those payments will be displayed on a public website starting next fall.

"A lot of items are going to be reported," Tom Sullivan, president of the medical consulting group Rockpointe Corporation in Columbia, Md., told MedPage Today in a phone interview.

There are a few exceptions, according to the American Academy of Family Physicians:

• Gifts or payments valued at less than $10 -- unless the aggregate amount paid to the physician exceeds $100 annually
• General food and drinks offered to all participants at conferences or large-scale events
• Educational materials and items intended for use by or with patients
• Samples intended for patient use, including coupons and vouchers for obtaining samples
• Payments or other transfers of value to residents

Medical groups also pushed hard for CMS to exempt speaker fees for accredited continuing medical education programs, which CMS granted. Publicly reporting such information would have a "chilling effect on doctors if they want to go to an accredited event that they'll show up on this public Open Payments database," Andy Rosenberg, JD, senior adviser at theCME Coalition, a group of CME sponsors and providers, told MedPage Today.

Pharmaceutical companies underwrite about a third of today's accredited CME programs, he said.

Programs approved by the Accreditation Council for Continuing Medical Education, the American Dental Association's Continuing Education Recognition Program, the American Academy of Family Physicians, the American Medical Association, and the American Osteopathic Association are exempt from public reporting.

Although data collection starts Thursday, CMS won't release the data on the public website till Sept. 20, 2014. Manufacturers must report the data to CMS by March 31, 2014. CMS will post the information on its website on June 30 in subsequest years.

But CMS will allow physicians 45 days to dispute the data before they are public, and doctors can seek corrections within a 2-year period. The agency and medical groups like theAmerican Medical Association are encouraging providers to take those steps and open a dialogue with patients about transparency.

Physicians can register with CMS starting Jan. 1 to receive a report on their activities each June before the public report is released. CMS also is pushing the smartphone application called "Open Payments Mobile for Physicians" which tracks payments and other value transfers manufacturers will report.

"Physicians can certainly access the website on which manufacturers report the information and see whether the information the manufacturers report matches the doctors' own understanding and then request revisions if they believe those are required," Alan Sager, professor of health policy and management at Boston University, told MedPage Today in a video interview.

Sullivan said he doesn't expect much to change in the doctor-drug company relationship, just more tracking and reporting on interactions between the two sides.

"I don't see pharma changing a whole lot of how they do business other than writing down who they do business with," Sullivan said.