Pulling the curtain back on long-hidden industry relationships, the federal government revealed that U.S. doctors and teaching hospitals had $3.5 billion worth of financial ties with drug and medical-device makers in the last five months of 2013. The details published in a new government database have been sought for years by consumer advocates and lawmakers concerned that conflicts of interest in the medical profession are jeopardizing patient care and costing taxpayer-funded health programs. This first batch of payment data covers just five months of 2013, but it shows the extensive ties medical companies have forged with doctors and academic medical centers across the country. About 546,000 U.S. physicians and 1,360 teaching hospitals received some form of compensation.
According to the story and analysis by the Los Angeles Times, California doctors and hospitals received 18% of the U.S. total, or $638 million, for the five-month period. In all, the data show nearly $2.5 billion in direct payments to medical providers – with 60% of that related to research. There was an additional $1 billion reported for medical providers’ ownership stakes in companies. That includes grants from companies and money that doctors invested themselves.
Advocates have long been concerned that this corporate largess – from speaking and consulting fees to luxury trips and meals – can lead to patients getting the wrong drugs or medical procedures. Those decisions can harm patients and drive up the nation’s $3-trillion medical tab, experts warn. Consumer advocates hailed the release of the information after years of debate in Congress and steadfast opposition from industry groups. “This exposure will require everybody to talk about something that’s been underground,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project in San Francisco. “It’s a widespread practice that does influence the kind of care patients get.”
The Physician Payments Sunshine Act, originally authored by Sen. Charles E. Grassley (R-Iowa), was included in the Affordable Care Act that President Obama signed in 2010 amid growing demands for more openness in the U.S. healthcare system. In the last several years, the Obama administration has lifted some of the secrecy by publishing data on how much hospitals charge for medical procedures and how much the massive federal Medicare program pays individual physicians. However, federal officials urged people not to rush to conclusions because financial ties between medical providers and manufacturers don’t necessarily signal wrongdoing. The database “does not identify which financial relationships are beneficial and which could cause conflicts of interest. It simply makes the data available to the public,” said Dr. Shantanu Agrawal, a deputy administrator at the Centers for Medicare and Medicaid Services.
Indeed, physicians and academic medical centers defend industry collaboration as essential to advance research into life-saving treatments. For example, drugs and devices that companies donate to doctors to use in their research are included in the database as company contributions. Critics also questioned the accuracy of the government data and the potential for doctors’ reputations to be tarnished unfairly. Similar complaints arose this year when Medicare published its physician payment data. “If the information made available to the public involves dollar amounts without full context, it can lead to gotcha-style news stories and healthcare providers facing the presumption of ethical wrongdoing even when they have done nothing wrong and their work is benefiting patients,” said Mary Grealy, president of the Healthcare Leadership Council, an association of medical industry leaders. Medical groups complained that physicians had not been given adequate opportunity to review the information before it was published.