Both the state and the federal government have passed laws requiring disclosure of drug and device payments made to doctors. The state’s law went into effect in 2009 and the federal law will take effect in 2013. Disclosure laws help reveal the extent of relationships between physicians and pharmaceutical companies. Drug companies provide physicians with gifts in the form of money, tickets, dinners, and a long list of other perks in exchange for speaking on behalf of a pharmaceutical company, promoting a drug or device to other doctors, or for simply listening to a representative’s sales pitch.
Extensive research has shown that this practice of gift giving can influence a physician’s prescribing habits. A New York Times article highlights research showing how physicians with these close ties are more likely to prescribe “newer and pricier drugs — whether or not they are in the best interests of patients”. This is both costly to our health system and the individual patient. By shedding light on these relationships, the disclosure laws aim to decrease these relationships, leading to lower costs and improved physician-patient relationships.
A new study by the Mongan Institute for Health Policy at Massachusetts General Hospital published in Archives of Internal Medicine (sub required) examines whether disclosure laws are having the intended effect on physician industry relations (PIRs). The study compares the result of a 2009 survey of 1891 physicians to a similar survey done in 2004, to see if the rates of PIRs are decreasing.
The researchers report that “on every measure the percentage of physicians with industry relationships was significantly lower in 2009 than in 2004.” This includes factors such as physicians accepting drug samples, payments for speaking engagements, and number of meetings with drug representatives. The researchers attribute this decrease to the disclosure legislation as well as the public’s negative response to PIRs.
Another important result was the effect of the industry relationships on a physician’s prescribing patterns. The study found that physicians with no industry ties were less likely to prescribe a brand-name drug when an equivalent generic was available. This affects the cost of health care, as brand name drugs are more expensive than their generic equivalent. Having physicians break these close ties to the pharmaceutical companies could result in increased substitution of equivalent generics, and less spending on pharmaceuticals.
The number of physicians reporting PIRs of any kind in this study is still high, at 83.8%. However, this is down significantly from 94% in 2004. This encouraging decrease shows that the medical community is responding to disclosure legislation and public opinion on industry relations. The Massachusetts’ gift ban and disclosure law is causing the intended effect: providing cost savings to consumers, improving health outcomes, and creating transparency for patients of potential conflicts of interests between industry and their providers.