For the first time Tuesday afternoon, there's new sunshine on the financial ties between drug and device companies and the doctors and teaching hospitals they target to use their products.
Thanks to a bipartisan transparency initiative contained in the 2010 Affordable Care Act, the federal government has compiled a massive database of how much drug and device companies spend on consulting fees, research grants, travel, free lunches and other items worth more than $10.
In just the last five months of 2013, the data show that 4.4 million such payments worth a combined $3.5 billion were made by these companies. Those payments went to 546,000 individual physicians and 1,360 teaching hospitals.
The rollout of this federal database has been somewhat problematic. Records aren't complete — about 40 percent of payments have been de-identified because of problems with the data. The Centers for Medicare and Medicaid Services, the agency publishing the database, is holding back other records that are still in dispute. It's also been difficult to navigate the database this afternoon. But these payments will be published on a regular basis, and the quality and reliability of the information is expected to improve.
CMS and others have stressed that financial ties alone aren't indicative of improper relationships. The industry defends the practice, saying it's an important way of educating health-care professional about new products.
These financial relationships, though, are ubiquitous. Ninety-four percent of physicians had a "relationship" with a drug or device company, a landmark 2007 New England Journal of Medicine study found. And the amount of money flowing in this arena is apparently much greater than previously known. ProPublica, which already was aggressively tracking these dollars, had kept a database detailing 3.4 million payments since 2009 worth $4 billion. That's about the same amount of activity in just the last five months of 2013, and that's even as ProPublica also found some big drugmakers had been scaling back payments to doctors for making promotional talks.
Previous surveys from the Pew Prescription Project found 78 percent of patients believed doctors accepting gifts from the industry influenced prescribing habits, which past research indicates is actually the case. But just 34 percent of patients told Pew they would likely ask doctors about their financial ties.
Again, just the fact that there are financial ties doesn't alone indicate wrongdoing. But as the release of Medicare physician payment data demonstrated earlier this year, the transparency can help root out bad actors, waste and curious outliers.