Legislation Would Shed Light on Industry Gifts to Physicians

Legislation introduced last month would require drug, biological product and medical device manufacturers with $100 million or more in annual gross revenues to disclose the names and office addresses of every physician who receives a gift valued at more than $25 from one of these companies.

The Physician Payments Sunshine Act, S.B. 2029, (at the THOMAS Web site, type "S 2029" in the search box after selecting "Bill Number") would apply to payments, honoraria, travel and other rewards to physicians from pharmaceutical companies or medical device manufacturers; drug samples and funding for clinical trials would be exempt.

Under the terms of the bill, which was introduced by Sens. Charles Grassley, R-Iowa, and Herb Kohl, D-Wis., gifts to physicians would be listed in a national database that would be created and maintained by HHS. The bill, which is pending in the Senate Finance Committee, would impose fines of $10,000 to $100,000 on the companies for each incidence of failing to report a gift.

The intent of the legislation is to let patients decide whether physician prescribing patterns are influenced by perks from the pharmaceutical, biological product and medical device industries. It attempts to augment similar initiatives in various states, including Minnesota, Vermont, Maine and West Virginia, and would not preempt state measures.

"Right now, the public has no way to know whether a doctor has been given money that might affect prescribing habits," said Grassley in a prepared statement. "This bill is about letting the sun shine in so that the public can know. Whether it's dinner at a restaurant or tens of thousands of dollars or more in fees and travel, patients shouldn't be in the dark about whether their doctors are getting money from drug and device makers."

According to guidelines developed by the AMA Council on Ethical and Judicial Affairs and supported by the AAFP, physicians cannot accept gifts of substantial value or those with conditions attached. The AMA guidelines also stipulate that all gifts must primarily benefit patients or be related to a physician's work.

At a June 27 Senate Special Committee on Aging hearing on the relationship between pharmaceutical companies and physicians, Marjorie Powell, senior assistant general counsel from the Pharmaceutical Research and Manufacturers of America, or PhRMA, testified (20-page PDF; About PDFs) that "PhRMA's member companies are committed to following the highest ethical standards as well as all legal requirements in their interactions with health care professionals." She also pointed out that the PhRMA Code on Interactions with Healthcare Professionals "is similar in many ways to the AMA's ethical opinion on Gifts to Physicians From Industry."

"This bill says, 'OK, if … you are comfortable with the process the way it is now, let's just get that out in the open, and we will let the public decide,'" said Ashley Glacel, Kohl's press secretary on the Senate Special Committee on Aging, in an interview with AAFP News Now. "We will let the public decide if they think these gifts and payments are egregious or not."

Glacel is optimistic about the bill's chances in the current Congress. She points out that the legislation has key bipartisan support -- Kohl is chair of the Senate's Special Committee on Aging, and Grassley is the ranking member on the Senate Finance Committee. Senate members also are talking with their colleagues in the House to get a House version of the legislation introduced.