The Physician Payments Sunshine Act: A Setback for Medical Progress
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The Physician Payments Sunshine Act: A Setback for Medical Progress
Drug Information Journal 46(3) 292-293 ª The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0092861512442022 http://dij.sagepub.com
Michael A. Weber, MD1
This year has brought in its wake the Physician Payments Sunshine Act and its requirement that pharmaceutical and device companies document all their payments to doctors, medical practices, and teaching hospitals so that, starting in 2013, these costs can be listed by the Center for Medicare and Medicaid Services on a public website. This action will result in unintended but not unforeseeable consequences on 21st-century medical progress. The Sunshine rules are unclear and complicated—a bad combination. Not only direct compensation to doctors but also all other costs of industry-supported physician-related research, consulting, and education will be reported. Why this drastic and invasive step? In a disingenuous preamble, the Sunshine Act asserts—unsupported by any evidence—that collaborations between physicians and industry might introduce conflicts of interest that could compromise research, education, and clinical integrity. But, in reality, the opposite is true. Collaborations between physicians and industry are fundamental to advancing medicine. Academic physicians have the experience to identify unmet clinical needs, advise on potential new treatments, design and conduct innovative research, and, through publications and teaching, bring vital new information to colleagues and patients. Without in any way diminishing the governmental and nonprofit agencies that support research, it is the partnership between physicians and industry that has created many, if not most, of the major medical breakthroughs that have reduced the rates of death and other serious outcomes in recent years—as any literature search of major medical journals will quickly confirm. Consider, for instance, some examples of collaborations between physicians and pharmaceutical companies in the cardiovascular area: the development of blood-pressure-lowering drugs that sharply cut stroke rates, drugs for fighting cholesterol that dramatically reduce heart attacks, and the creation of treatments for patients with diabetes that protect kidneys and delay or prevent the need for dialysis. What, then, is the real agenda of the Sunshine Act? It’s all about money. Its supporters hope that physicians, seeing their
compensation made public, will curtail their interactions with industry—thus limiting the development and use of ‘‘expensive’’ new products. Understandably, government and private health insurers want to keep costs stable. And with prescription copays being patients’ most visible expense, they might find this action appealing—for a while—until they see how new treatments and their uptake are seriously delayed. Still, the reasoning behind the Sunshine Act’s attack on physicians completely misses the point. True, physicians have contributed to increased health care costs, but only a
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