Physician Payments Sunshine Act would call for full disclosure

The relationship between physicians and drug and device companies are starting to attract the attention of legislators, other physicians, and the public as questions are raised about how much influence these companies have on physicians who accept gifts or financial compensation. A new bill introduced Sept. 6 by Sen. Charles Grassley (R-IA), the Physician Payments Sunshine Act, requires drug and medical device manufacturers with revenues greater than $100 million to declare publicly the amount of money they pay physicians.

Both physicians and industry would say they pursue these relationships to help patients. Although that sounds altruistic, drug and device manufacturers also have another audience to please: their shareholders, who hope that their investment in these physicians will boost sales.

Now these relationships are starting to attract the attention of legislators, other physicians, and the public as questions are raised about how much influence drug and device companies have on physicians who accept gifts or financial compensation.

"Companies wouldn't be paying this money unless it had a direct effect on the prescriptions doctors write and the medical devices they use," Sen. Grassley said on the Senate floor as he introduced the bill.

Meanwhile, the American Academy of Ophthalmology (AAO) is considering a tougher stance on disclosure of financial interest. H. Dunbar Hoskins Jr., MD, the association's executive vice president, said members are reviewing a policy that requires AAO peer-review committees to "manage" the conflict of interest rather than simply disclose it. One speaker with financial ties to a company might be paired with another speaker from another company for a balanced presentation, he said.

Full disclosure

Sen. Grassley said he was driven to pursue this kind of public disclosure after learning that a child psychiatrist had been paid more than $100,000 in 2003 as a drug consultant. Her studies of that company's pediatric antipsychotic medicine led to widespread use of the drug, he said in a speech on the Senate floor.

His bill already has the support of several key senators, including Sens. Clair McCaskill (D-MO), Amy Klobuchar (D-MN), Ted Kennedy (D-MA), Herb Kohl (D-WI), and Chuck Schumer (D-NY).