Shunshine Act

The Physician Payment Sunshine Act (PPSA) is intended to expose any financial relationships that could compromise a physician’s research integrity or patient care. In response to the PPSA, CMS created the “Open Payments” database, into which device-drug-supply manufacturers publicly report any financial transfers to physicians or teaching hospitals. This includes 3 types of payments: “general” payments, research payments, and physician ownership information.

The database was released last week and contains ~2/3 of the payments made by manufacturers in the last 5 months of 2013, including $3.5 billion made to 1,360 teaching hospitals and 560,000 physicians.1

While the intent of the Sunshine Act seems laudable, there are flaws that should be considered by those attempting to digest the information included in the database. As outlined by a recent Annals article, the inclusion of research funding (which includes donated drugs) can result in extraordinary dollars attributed to well-meaning and successfully funded researchers.2 In addition, 1/3 of the data was not released due to concerns about the data integrity; even the existing data contained within the database did not undergo any validation steps or public comment period (by the physician and/or teaching hospital).

It is not clear how this data will be used by the public or by physicians, or whether it will change the behavior of either group. But I am almost certain it will cause all physicians to reconsider the risk and benefits of any financial relationship with manufacturers, regardless of its nature.

1. http://www.cms.gov/openpayments/index.html

2. http://annals.org/article.aspx?articleid=1910341

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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