Patients need to know if their doctor receives all-expense-paid trips from a drug company whose products he enthusiastically prescribes. It is relevant to evaluating whether a doctor is practicing ethical medicine or using a prescription pad to write his way to another ritzy convention. While there has been no routine way to ferret out this conflict of interest, that's about to change. A rule being finalized by the Obama administration would require drug companies and medical device makers to disclose all gifts or payments made to doctors. The new consumer protection is yet another benefit of the Affordable Care Act, President Barack Obama's signature health care reform law, and will soon give patients a clearer picture of how their doctors do business.
It is an open secret that drug and medical device makers are awfully generous to doctors and medical staff in efforts to generate higher sales. Free trips to luxury resorts, excessive payments for lectures, research, advice and "consulting," expensive restaurant meals, and treating an entire office to lunch are not unusual. Those receiving the benefits and those doling them out defend the practice as a collaboration that leads to medical innovation, and certainly that is true in some cases. But this cozy relationship is also rife with abuse.
According to an analysis by the New York Times, about 1 in 4 doctors take cash payments from drug or device makers, and nearly 2 out of 3 take free food for themselves and their staff. Those who do take money, according to the findings, are more willing to prescribe drugs in unapproved and potentially risky ways. That culture can also lead to excess prescribing of expensive brand-name drugs over cheaper alternatives, and to overlooking a product's drawbacks.
The new standards will require companies that have a product covered by Medicare or Medicaid to disclose financial ties to doctors. Every financial expenditure has to be opened to the public, from regular payments to doctors to the delivery of doughnuts and coffee to a medical office. That information will be posted on a publicly accessible website by the federal government. Patients will be able to learn whether their doctor might have a conflict of interest when recommending a certain medication or medical device, and the public scrutiny will translate into doctors being more cautious about receiving gifts.
The idea was a bipartisan one, pushed by Sens. Charles Grassley, R-Iowa, and Herb Kohl, D-Wis. It landed in the 2010 health reform law, joining a long list of consumer protections that the law has put in place, such as requiring health insurers to offer coverage for young people until they turn 26 and requiring health insurers to spend at least 80 percent of each premium dollar on health care.
Whether the disclosure rules will result in cost savings remains to be seen. But what is certain is that the move will give patients the information to make more responsible choices, and it will bring new accountability to doctors whose medical judgment may be clouded by drug company largesse.