Is the Sunshine Act reducing conflicts of interest?

A little over ten years after the Physician Payments Sunshine Act was passed, how have industry payments to physicians changed? A recent article in Medscape explores the impact of the legislation, obstacles to change, and potential solutions beyond just disclosure.

The Sunshine Act, which mandates that drug and device companies publicly report all the gifts and other payments they give to physicians, has certainly improved transparency. But that doesn’t necessarily mean that it’s changing behavior. A big reason why is that the onus is largely on patients to research their doctor’s conflicts, and many patients don’t have the time or interest to do that. “There is no doctor who’s going to say, ‘I was given this money from a company and that’s why I prescribed those drugs,'” said Lown Institute health policy and communications fellow Judith Garber, in Medscape.

While the disclosure of payments is helpful for those doing research on conflicts of interest, “It doesn’t seem like it’s causing change in the behavior of payments to physicians,” said Garber. An exception to the pattern is family practice, in which more residencies have become pharma-free over time, according to a recent study in the Journal of the American Board of Family Medicine.

Other experts quoted in the piece concurred that disclosure alone is not doing enough to curb conflicts of interest. We need more visibility of these payments (maybe signs at doctor’s offices that disclose how much they were paid by pharma) and more limits on payments from the government or other actors. “Disclosure is not the answer to this,” said Dr. Adam Urato, chief of maternal and fetal medicine at MetroWest Medical Center in Framingham, Massachusetts, and member of the Lown List of Independent Experts, in Medscape. “We’re not solving the problem. It’s a relationship that’s broken.”

For more, read the full piece in Medscape!