Physician Payments Sunshine Act

United States healthcare law

This article is about the Physician Payments Sunshine Act. Not to be confused with Government in the Sunshine Act.

The Physician Payments Sunshine Act is a 2010 United States healthcare law to increase transparency of financial relationships between health care providers and pharmaceutical or medical device manufacturers.

## About

[edit]

The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS). The goal of the law is to increase the transparency of financial relationships between health care providers and pharmaceutical manufacturers and to uncover potential conflicts of interest.[1] The bill allows states to enact "additional requirements", as six states already had industry-pay disclosure laws.[2]

In 2013, the American Medical Association offered physicians training to understand the Sunshine Act.[3]

A recent 2024 analysis suggests nearly 60% of experts who reviewed manuscripts for four major medical journals received at least one payment from the industry over a recent three-year period, with a total exceeding $1 billion.[4] From 2020 to 2022, 1,155 of the 1,962 reviewers for The BMJ, JAMA, The Lancet, and The New England Journal of Medicine received payments.[5] More than half of these reviewers—1,060—accepted general payments for activities like travel, speaking, consulting, and meals, while 623 reviewers (32%) received research-related payments. Of the $1.06 billion in total payments, $1 billion went towards research, including payments to individual physicians and institutions where reviewers served as principal investigators in clinical studies.

## History

[edit]

The Sunshine Act was first introduced in 2007 by senior US Senator Charles Grassley, a Republican from Iowa and Senator Herb Kohl from Wisconsin, a member of the Democratic Party.[6] The act was introduced independently and failed. After debate by various groups [2] it was enacted along with the 2010 Patient Protection and Affordable Care Act.[citation needed]

In 2011, it was proposed to use identification systems on tracked physicians.[7]

On September 30, 2014, the Centers for Medicare and Medicaid Services reported payment information on its Open Payment Program website for the first time, the data from 2012.[8]

## Criticism

[edit]

In 2012 it was suggested that the act may have a limited effect on prescribing and on expenditures.[9]

A 2015 opinion piece in JAMA stated that the value of transparency was beyond dispute, but "the true value of the database remains uncertain and probably too early to ascertain".[10]

## International comparison

[edit]

There is no agreement on appropriate standards of disclosure internationally.[11]

Australia was one of the first countries that has, since mid-2007, required reporting of details of every industry-sponsored event. Data are publicly posted, updated every six months and downloadable as pdf only. A 2009 study found modest expenditure at individual events, but high cumulatively, particularly for prescribers of high cost drugs like oncologists, endocrinologists, and cardiologists. It concluded disclosure requirements fell short of what is required and proposed more comprehensive data collections.[11]

In The Netherlands the Transparantieregister Zorg was founded in 2013, that requires full disclosure of payments above 500 euro from pharmaceutical companies and manufacturers of medical devices to healthcare workers, patient organizations et cetera. The effectiveness of this register will be evaluated in 2019.

## References

[edit]

1. ^ "S.301 - Physician Payments Sunshine Act of 2009 - 111th Congress (2009-2010)". Library of Congress (Congress.gov). 2009. Retrieved 2017-04-13.
2. ^ a b O'Reilly, Kevin B. (23 February 2009). "'Sunshine' bill sets $100 trigger for disclosing drug industry pay to doctors". American Medical News. Retrieved 3 June 2013.
3. ^ Lazarus, Jeremy (12 April 2013). "The Physician Payment Sunshine Act is here: Are you ready?". kevinmd.com. Retrieved 3 June 2013.
4. ^ Silverman, Ed (2024-10-10). "Medical journal peer reviewers are paid millions by industry, study finds". STAT. Retrieved 2024-10-12.
5. ^ Nguyen, David-Dan; Muramaya, Anju; Nguyen, Anna-Lisa; Cheng, Alan; Murad, Liam; Satkunasivam, Raj; Wallis, Christopher J. D. (2024-10-10). "Payments by Drug and Medical Device Manufacturers to US Peer Reviewers of Major Medical Journals". JAMA. doi:10.1001/jama.2024.17681. ISSN 0098-7484.
6. ^ Campbell, E. G. (2007). "Doctors and Drug Companies — Scrutinizing Influential Relationships". New England Journal of Medicine. 357 (18): 1796–1797\. doi:10.1056/NEJMp078141. PMID 17978288.1796-1797&rft.date=2007&rft_id=info:doi/10.1056/NEJMp078141&rft_id=info:pmid/17978288&rft.aulast=Campbell&rft.aufirst=E.+G.&rft_id=https://doi.org/10.1056%2FNEJMp078141&rfr_id=info:sid/en.wikipedia.org:Physician+Payments+Sunshine+Act" class="Z3988">
7. ^ Carpenter, D. (2011). "A Unique Researcher Identifier for the Physician Payments Sunshine Act". JAMA: The Journal of the American Medical Association. 305 (19): 2007–2008\. doi:10.1001/jama.2011.651. PMC 3143068. PMID 21586717.2007-2008&rft.date=2011&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143068#id-name=PMC&rft_id=info:pmid/21586717&rft_id=info:doi/10.1001/jama.2011.651&rft.aulast=Carpenter&rft.aufirst=D.&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143068&rfr_id=info:sid/en.wikipedia.org:Physician+Payments+Sunshine+Act" class="Z3988">
8. ^ "Physician Financial Transparency Reports (Sunshine Act)". American Medical Association. 2013. Retrieved 3 June 2013. `{{cite journal}}`: Cite journal requires `|journal=` (help)
9. ^ Pham-Kanter G, Alexander GC, Nair K (2012). "Effect of financial disclosure laws on physician prescribing". Archives of Internal Medicine. 172 (10): 819–821\. doi:10.1001/archinternmed.2012.1210. PMC 4007047. PMID 22636826.819-821&rft.date=2012&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007047#id-name=PMC&rft_id=info:pmid/22636826&rft_id=info:doi/10.1001/archinternmed.2012.1210&rft.aulast=Pham-Kanter&rft.aufirst=G&rft.au=Alexander,+GC&rft.au=Nair,+K&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007047&rfr_id=info:sid/en.wikipedia.org:Physician+Payments+Sunshine+Act" class="Z3988">
10. ^ Perlis, Roy H.; Perlis, Clifford S. (2016-05-16). "Physician Payments from Industry Are Associated with Greater Medicare Part D Prescribing Costs". PLOS ONE. 11 (5): e0155474. Bibcode:2016PLoSO..1155474P. doi:10.1371/journal.pone.0155474. ISSN 1932-6203. PMC 4868346. PMID 27183221.
11. ^ a b Jane Robertson; Ray Moynihan; Emily Walkom; Lisa Bero; David Henry (3 November 2009). "Mandatory Disclosure of Pharmaceutical Industry-Funded Events for Health Professionals". PLOS Medicine. 6 (11): e1000128. doi:10.1371/journal.pmed.1000128. PMC 2764857. PMID 19885393.

## External links

[edit]

* "Open Payments". Centers for Medicaid and Medicare Services. n.d.
* "Physician Financial Transparency Reports (Sunshine Act)". American Medical Association. n.d.