The data are categorized into three types of records—research payments, such as funding for a clinical trial; non-research payments, including funding for travel, speaker's bureaus or gifts and meals; and physician ownership or investment in manufacturers or group purchasing organizations.
In total, manufacturers made 4.4 million payments totaling at least $3.5 billion to 546,000 physicians and 1,360 teaching hospitals during the last five months of 2013, according to the CMS. More records will be published for this period next year as the agency corrects some data.
The healthcare community was anxiously watching the initial presentation of the data. Despite some technical glitches during the preliminary rollout to doctors when they were able to review their data for accuracy, and some alarms about data on different doctors being intermingled, Tuesday's launch appeared to proceed smoothly, unlike the CMS rollout of the HealthCare.gov insurance enrollment website fall.
While some manufacturers previously have disclosed payments—including payments for promotional work as well as for research— voluntarily or under corporate integrity agreements, the new database is the first national, publicly available resource for such information. Much of the speculation about the launch of the data has focused on whether the CMS would provide context for the different types of payments made by industry to providers, enabling consumers to understand what the payments represent and how they can promote healthcare research and better quality of care.
The website did offer a page of explanation about the payment information. “Just because there are financial ties doesn't mean that anyone is doing anything wrong,” the CMS wrote. “Transparency will shed light on the nature and extent of these financial relationships and will hopefully discourage the development of inappropriate relationships.”
Mark Leahey, CEO of the Medical Device Manufacturers Association, said “the collaboration between physicians and innovators remains a core tenant in the development and improvement of medical technologies, and policies must foster the communication and education required to maintain our global leadership position.”
The American Medical Association, which has been sharply critical of the review process leading up to the launch and had urged a delay in the launch of the website, again raised questions about the accuracy of the data. Only 26,000 physicians—about 5% of the physicians listed in the data—had reviewed their records, according to the CMS.
“Patients deserve to have access to accurate information, yet publishing inaccurate data leads to misinterpretations, harms reputations and undermines the trust that patients have in their physicians,” Dr. Robert Wah, president of the AMA, said in a written statement.
But advocates of the law praised the launch. Pew's Coukell noted it's the first time there is publicly available information about how much manufacturers spend on such payments and the number of teaching hospitals and physicians who have financial relationships with industry. “Some financial relationships between manufacturers and doctors are necessary and beneficial, and reflect the collaboration between medicine and industry that generates new knowledge and advances patient care,” he said. “Other gifts and payments—those associated with marketing—add expense to already unsustainable healthcare costs and create conflicts of interest.”
“Consumers deserve to know the financial relationships among these players,” Lisa Swirsky, senior policy analyst for Consumers Union, the advocacy arm of Consumer Reports, said in a written statement. “These manufacturers need to put more focus on research, less focus on marketing, and we hope this kind of financial transparency will encourage that.”
In addition to publishing information about payments made to doctors, the Open Payments website will present data on the financial relationships between teaching hospitals and manufacturers and the potential conflicts of interest those relationships create.
The American Medical Student Association on Sept. 29 released its annual scorecard evaluating conflict-of-interest policies at 204 academic medical centers and 160 medical schools. The group said policies at these institutions generally fall short, noting that only 19% of teaching hospitals had policies requiring disclosure of potential conflicts of interest to the public.
There are questions about what groups will use the data disclosed on the Open Payments website. While the Sunshine Act was intended to help patients understand potential conflicts of interest, some experts say the data may be used by government investigators and insurers tracking doctors' prescribing, surgical and other practice patterns. “Anyone who is paying for medical services of various types is going to be interested in this,” said Dan Kracov, a partner with law firm Arnold & Porter.
The CMS has proposed requiring disclosure of payments by manufacturers to doctors providing continuing medical education, but that data will not be included in the first round.
Follow Jaimy Lee on Twitter: @MHjlee
