Should Physicians Disclose Gifts From Drug Manufacturers?

The Nov. 1, 2007 issue of the New England Journal of Medicine has an article encouraging federal legislation to require pharmaceutical and medical device companies with more than $100 million in revenue to disclose the amount of money and gifts they give to physicians. The bill, entitled the “Physician Payment Sunshine Act,” is “about letting the sun shine in so that the public can know” about these relationships, according to one of its sponsors, Senator Charles Grassley.

From the article:

Indeed, the nature, extent, and consequences of physicians’ relationships with industry have become one of the most fiercely debated issues in health care today. At the simplest level, such a relationship exists whenever a physician accepts anything from a company whose products or services are related to the practice of medicine. And such interactions are ubiquitous: according to a recent survey, although the frequency and intensity of the ties vary according to physicians’ personal and professional characteristics, virtually all physicians (94%) have some type of relationship with industry.

Most commonly, physicians report receiving food and beverages in the workplace (83%) or being given drug samples by a manufacturer’s representative (78%). More than one third of physicians (35%) receive reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) receive payments for consulting, speaking, or enrolling patients in trials.

From a policy perspective, the debate centers on the overall effect of these relationships on patient care. Although most physicians deny that receiving free lunches, subsidized trips, or other gifts from pharmaceutical companies has any effect on their practices, research has shown that physician–industry relationships do influence prescribing behavior.  After all, if these relationships didn’t affect physician behavior in such a way as to increase sales, companies wouldn’t spend $19 billion each year establishing and maintaining them.

Now certainly, there are benefits to these relationships (free samples, increased education, etc) and there are good arguments to be made not to ban them, but could it hurt to have a system that would allow patients to find out whether the physicians that prescribe medication are receiving substantial benefits from the manufacturers of the drugs that they’re prescribing?

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