Impact of the Sunshine Act remains unclear


Two years after the Physician Payment Sunshine Act publicly revealed how much money physicians accepted from drug and device manufacturers, it’s still unclear how the legislation has influenced providers’ willingness to accept payments or change prescribing practices.

The law appears to have minimal impact on reducing the influence of manufacturer payments, according to an article in The BMJ. Survey data shows that physicians have fewer industry ties compared to 12 years ago, but the varying structure of prior surveys raises questions about whether physicians really are less likely to take money or less biased in their prescribing habits.

Furthermore, policy experts told The BMJ that the act leaves out several financial relationships that could influence healthcare services beyond drugs or devices, echoing previous complaints that the law is still too limited. By publicly posting payments on the Centers for Medicare & Medicaid Service Open Payments website, some argue the law has transferred the responsibility to the patient to decipher multifaceted financial relationships.

"Putting the onus on patients to navigate physicians' conflicts of interest may not be realistic because most US doctors have financial ties to industry," BMJ Associate Editor Jeanne Lenzer wrote. "Nor can the public readily decipher the meaning of a physician’s tie to a particular company because drug companies have multiple and complex marketing, distribution, and licensing ties to other companies."

In 2015, physicians and hospitals received $7.52 billion from drug and device manufacturers, including $2.6 billion in non-research related payments and $1 billion in ownership ties. At least one loophole within the Sunshine Act is scheduled to close next year, requiring manufacturers to report the value of continuing education sessions, medical journal reprints and textbooks provided to doctors.