Drug and medical-device companies paid at least $3.5 billion
to U.S. physicians and teaching hospitals during the final five months of last
year, according to the most comprehensive accounting so far of the
financial ties that some critics say have compromised medical care.
The figures come from a new federal government
transparency initiative. The 2010 Affordable Care Act included a provision
dubbed the Sunshine Act, which requires manufacturers of drugs and medical
devices to disclose the payments they make to physicians and teaching hospitals
each year for services such as consulting or research. The Centers for Medicare
and Medicaid Services compiled the records into a database posted online
Tuesday, though the agency said that about 40% of the payment information won't
identify the recipients because of data problems.
The database revealed totals, such as the $122.5 million
paid by Roche Holding AG's Genentech unit to City of Hope medical center
in Duarte, Calif., as royalties on sales of several products including
blockbuster cancer treatments Herceptin and Avastin.
Genentech licensed patents from City of Hope based on
research the medical center conducted in the early 1980s. The company said that
excluding the City of Hope royalties, about 85% of the physician payments it
reported to CMS were focused on drug research. City of Hope said the royalties
are allocated to the inventors and to support continuing research.
The push for greater transparency was driven by concerns
that doctors' prescribing decisions are tainted by the money and gifts they
receive each year from companies. Supporters expect the transparency initiative
to provide useful information to patients about the relationships their doctors
have with industry and to curb the influence of payments on medical care.
Companies have defended their payments to physicians as
necessary to conduct research and communicate how products should be used. The
payments and so-called transfers of value to an estimated 546,000 doctors and
1,360 teaching hospitals include such items as free meals that company sales
representatives bring to physicians' offices, fees paid to doctors to speak
about a company's drug to other doctors at restaurants, compensation for
clinical trial research and consulting fees.
Some doctors have earned tens of thousands of dollars
annually from drug companies by flying to various cities to give paid speeches,
while some surgeons have received even larger amounts from medical-device
makers, partly from royalties on products they helped develop.
Doctors have expressed concern about having their names
attached to money paid by industry. Some have scaled back their interactions
with industry because they know it will be reported publicly.
The first batch of data released by CMS on Tuesday covers
payments made from Aug. 1 to Dec. 31, 2013. Beginning next year, companies will
report full-year data annually. Companies submitted the data to CMS earlier
this year, using the so-called Open Payments portal. The agency has allowed
physicians to register with the Open Payments system to get a preview of the
payment records, before it went public, to allow time for them to dispute any
reports they believed were inaccurate.
But it hasn't been a smooth process. First, CMS delayed the
public reporting of the data by a year to give companies more time to prepare.
The Open Payments online system has experienced technical problems, including a
data mix-up that resulted in some doctors being linked to payment records for
other doctors with the same surname. The preview function for doctors had a
cumbersome registration process and was taken offline at times in recent weeks.
The first batch of data is incomplete. CMS in August said it
removed about one-third of the payment records from the physician-preview
database because it said some of the state medical-license numbers that
companies reported for doctors didn't match a database that the agency was
using for verification, among other problems. CMS now is releasing those
records but without identifying the physicians tied to them. It will update the
database to include the physicians' names for those records next year.
The agency's handling of the problematic records also has
drawn criticism from companies, which said they reported the vast majority of
data properly. About $22 million in physician-payment records reported Eli
Lilly for the five-month period of last year, for example, was removed from the
physician-preview database, out of a total reported of about $85 million. Industry
and medical groups also have complained that CMS didn't offer advance
information about how the data would be presented publicly.
here to access the full article on The Wall Street Journal.