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EDITOR’S PERSPECTIVE

LET THE SUNSHINE IN

The Physicians Payment Sunshine Act of 2010 is a U.S. Federal law intended to increase transparency between healthcare providers and the healthcare/pharmaceutical industry. Its overall goal is to improve understanding of potential conflicts of interest that may be associated with physician prescribing patterns. The law requires that drug and medical device and supply manufacturers collect and report financial transactions occurring between themselves and physicians and teaching hospitals. The data are collected by the U.S. Centers for Medicaid and Medicare Services and were reported for the first time publicly on Sept. 30, 2014. ProPublica reports that these companies pay about $2 billion to more than 600,000 practitioners per year (www.propublica.org/article/updated-dollars-for-docs-heres-whats-new ).

While the intentions of the law are good, many questions and controversies remain. Are physicians who are paid by the industry actually more likely to prescribe company-affiliated drugs and devices? Was the law actually effective in reducing potential biases in prescribing patterns of physicians? Is there international consensus on this sort of reporting, and how are those efforts aligned?

I was recently reading a column in Car and Driver called “A Capital Idea: Sensing opportunity amid the chaos, the auto industry is spending big on lobbying.” It was focused on current issues facing the U.S. auto industry and how that industry was responding—largely through its lobbying efforts. The article stated that the auto industry spent nearly $70 million on lobbying efforts in 2017. However, it was only number 17 on the list of industry spending on lobbying efforts.

Guess what was number one? Pharmaceutical and healthcare products! This industry spent a staggering $279 million on lobbying efforts, which was almost double compared to the second-highest category (insurance). While this is only a fraction of the dollars paid to physicians, it still is a reminder that we need to keep open lines of transparency on all involved in the regulatory and oversight process.