The Centers for Medicare & Medicaid Services (CMS) has published a new update on industry payments to doctors, as required by the "Sunshine" provision of the Affordable Care Act, but the significance of the reported information varies depending upon whom you ask.
Overall, 1,617 companies reported 15.7 million payments valued at $9.9 billion from August 2013 until the end of 2014. Nearly all of those payments--14.9 million--were classified as "general payments," covering promotional speaking, consulting, meals, travel and royalties totaling $3.5 billion over the 17-month period, according to a ProPublica analysis of the data.
While some standout physicians received payments ranging in size nearly every working day of the year, most doctors received only one or two pharma-sponsored meals, ProPublica's Charles Ornstein told NPR.
Reported payments also varied by region and specialty. The state with the highest earners was California with $806 million in payments to doctors, followed by New York ($312 million), Texas ($243 million) and Florida ($188 million), according to the data. Meanwhile, rheumatologists, endocrinologists, electrophysiologists and interventional cardiologists reported the most interactions with drug and device companies, according to an article from MedPage Today.
Many of the highest-paid doctors declined to talk to the media after the data's release, but others defended their relationships with the industry. For example, Charles Birbira, M.D., a Massachusetts internist, told GoLocalWorcester that his receipt of more than $15,000 in payments from drug companies helped bring drugs such as Humira and others to the market. "We help advance the science of medicine, he told the newspaper. "Without the clinical trials that we do, no new medications would come to the marketplace. We make sure medications work properly."
The ProPublica database is open to the public, but Ornstein doesn't believe it's a threat to physician-patient relationships. "They may look it up out of curiosity, but it's not going to cause them to change doctors," he told NPR. The data may influence patients to choose different physicians, however, if they already had doubts about their doctor's prescribing habits and then learn industry payments may play a role, he added.
Nonetheless, the American Medical Association (AMA) still isn't satisfied that physicians have a reasonable opportunity to correct flawed information in the database. "The [AMA] is committed to transparency and the availability of information for patients to make informed decisions about their medical care," according to a statement released last week. "Unfortunately, the vast majority of the data released today has not been independently validated by physicians, which makes it less usable for the patients it's intended to benefit."