The Centers for Medicare and Medicaid Services issued a long-awaited rule Friday finalizing the details for a database that will list payments made to physicians by pharmaceutical and medical device, manufacturers.
What factors does your doctor take into account when making decisions about your treatment? Your symptoms certainly. Your medical history almost certainly. But do they also decide on your medication or medical apparatus, based upon the business arrangement they have with the companies providing those drugs or that machinery? How can they not? But doesnâ€™t the patient have a right to know all about those business relationships and how it may affect their doctorâ€™s decision making? Absolutely, because it informs the discussion between patient and medic.
There is now a rule to make full disclosure of this information mandatory. It is a provision of the Â Affordable Care Act . It is called the â€˜physician payments sunshine actâ€™. Â It makes clear the requirement for makers of drugs, medical devices, biomedicals, and all medical provisions, under Medicare, Medicaid, or the Children’sÂ HealthÂ Insurance Program, to declare payments or any other value transactions between them and doctors and teaching hospitals. The declarations must be made to CMS, centers for Medicare and Medicaid services. They in turn will publish the information on an open website. So if your doctor has any ownership or investment interests in your prescription you can know about it before the prescription is made.
The declarations of interest will be collated from August 1st this year. The deadline for declaration from August to December, will be the end of March next year. CMS are in the development stages of the software but aim to publish the data by September 2014. The aim of all this, is to overcome conflicts of interest between doctors, teaching institutes and patients, created because the former are in the pockets of â€˜big pharmaâ€™.
The American Medical Association, or AMA, agree wholeheartedly with the principle of full disclosure of the exact relationships between their members and the pharmaceutical industry. In a statement the top man says:
“Physicians’ relationships with the pharmaceutical industry should be transparent and focused on benefits to patients … As the rule is implemented, we will work to make sure physicians have up-to-date information about the new reporting process.”
But they will carefully review the practice of the rule
Advocates of the sunshine rule are impatient to see it implemented. They live in the hope that publishing, for all who care look, to see, the money crossovers between the medical industry and the medical practitioners. They are looking forward to a return of trust between patients and medics and for them, it cannot come soon enough. They have been criticizing the CMS for taking too long to bring about this change.
The law was first put into place 3 years ago and there are still another two years to go before the information becomes available. Blame for the delay seems to be focussing on the White House Office of Management and Budget. An august body, made up of well-known doctors at the top of their profession, wrote to the White House, saying:
“Financial relationships between physicians and drug and medical device companies can create conflicts of interest that threaten the quality of patient care and drive up healthcare costs…As our nation struggles with these problems, it is imperative that the administration implement the Sunshine Act without any further delay.”