MedPAC Finalizes Recommendations on Disclosing Financial Ties Between Physicians, Manufacturers

By James Arvantes • Washington
11/12/2008

Congress should require drug and device manufacturers to reveal their financial ties with physicians and other health care providers as a way of discouraging inappropriate financial arrangements between the entities, according to a series of recommendations recently adopted by the Medicare Payment Advisory Commission, or MedPAC.

MedPAC adopted five recommendations relating to financial disclosure during a two-day meeting (442-page PDF; About PDFs) here on Nov. 6 and will submit them to Congress as part of its annual report in March.

MedPAC is recommending that Congress

require all manufacturers, distributors and their subsidiaries to report financial relationships with physicians, pharmacists, pharmaceutical benefits managers, hospitals, medical schools, and medical or health organizations;
direct HHS to post information on financial relationships in a searchable format on a public Web site;
require manufacturers and distributors to report information on who receives drug samples;
require all privately owned hospitals and other entities that bill Medicare for services to reveal the names of physicians who directly or indirectly own an interest in that hospital or entity and to post the information on a Web site; and
ask HHS to submit a report on the types and prevalence of financial relationships between hospitals and physicians.

"All we are asking is that companies disclose their relationships and their ownership in various facilities," said FP Thomas Dean, M.D., of Wessington Springs, S.D., in an interview with AAFP News Now.

"I don't think (these recommendations) should hurt anyone who is comfortable with their (financial) relationships," added Dean, who is the only family physician on MedPAC.

Dean said the recommendations are a way to address perceived conflicts of interest between physicians and other entities. It's a way of "proving we are patient advocates and not just in this for our own benefit," he said.

However, Dean said he voted against the recommendation that companies report on the free drug samples they distribute to physicians. Although Dean said he supports the intent of the recommendation, drug samples are distributed in such a way it is virtually impossible to track sample use by individual physicians. Without that information, the MedPAC recommendation would have little effect on physician prescribing patterns, resulting in an inefficient use of time and resources, said Dean.

"I am just uneasy that we're going to be able to get the kind of data through this mechanism that we need or that it's likely to affect any of the kind of behavior changes that we're interested in," he said during the meeting.

According to MedPAC, the pharmaceutical industry in 2005 provided free samples worth $18.4 billion to physicians. Critics of the practice say the free samples perpetuate the use of more expensive medications and influence prescribing decisions.

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