Sen. Charles Grassley, R-Iowa

Sen. Charles Grassley, R-Iowa, has asked 33 of the largest medical societies for detailed information on the funding they receive annually from pharmaceutical and medical equipment companies for everything from research to continuing medical education. The deadline to respond was Monday, December 21.

"I’m interested in transparency,” said Grassley, the ranking member of the Senate Finance Committee, in a press release. “Letting the sun shine in and making information public is basic to building people’s confidence in medical research, education, and the practice of medicine,” he added. Grassley is a sponsor of the Physician Payments Sunshine Act. The bill, if passed, would require annual public reporting by drug, medical device, and biologic drugs manufacturers of payments made to physicians nationwide.

Specifically, Grassley wants the 33 medical groups to detail the amount of money received from industry each year going back to 2006. The associations were asked to include whom the money came from and what it was used for. He also asked them to explain their policies on accepting industry funding as well as their disclosure requirements.

Grassley’s Letter

In a December 7 letter to the societies, Grassley expounded on the reasons for the inquiry. “For the last three years, the Committee has been looking into various aspects of the pharmaceutical industry, including consulting arrangements, and industry funding for Continuing Medical Education,” wrote Grassley. “My inquiry was spurred, in part by press accounts documenting the lack of transparency in the relationships between the pharmaceutical industry and nonprofit organizations.”

Grassley cited the case of the National Alliance on Mental Illness, to which he sent an inquiry in October after reading reports that it had close ties to the drug industry. The inquiry revealed that NAMI received about two-thirds of its funding from the drug industry, causing one member of its board of directors to resign in shock. Since then, Grassley explained in the letter, NAMI has decided to publicly disclose on its Web site any funding over $5,000 received from industry. “This decision in favor of transparency by NAMI is encouraging,” wrote Grassley.

What Societies Think

Norman Kahn, executive vice president and chief executive officer at the Council of Medical Specialty Societies, Chicago, says the societies are taking the inquiry very seriously and were planning to comply with the request. Most intended to meet the December 21 deadline, he added.

Among those complying with the request is the American Academy of Family Physicians. “The AAFP and its leadership hold the tenet of transparency to be among the most important elements of professionalism. We believe strongly that safeguards must be in place to insure independence, validity, and relevance of the services we provide our members, because no organization can sustain the trust of its members without such safeguards and openness,” wrote Doug Henley, executive vice president, AAFP, in a statement. Henley said that 11 percent of AAFP’s income came from pharmaceutical companies in fiscal year 2009-2010.

Other associations contacted for this story, including the American Dental Association and the American Hospital Association, were in the process of putting together the information for Grassley at press time.

In conversations with Grassley staffers, Kahn came away encouraged by the committee’s understanding of CME. “To their credit, they understand that there’s a difference between CME grants and other funding—particularly a difference between CME grants to societies and individual payments to physicians,” says Kahn. “The second thing I was heartened to hear is that they are all about transparency and disclosure.” They recognize, he says, that CME grants aren’t illegal, “they just want them to be accurately disclosed.” And since that is something that medical societies support, “they are ready, willing, and able to comply,” he says.

While studies have shown that direct payments to physicians have influenced behavior, there has never been any evidence that industry funding influences certified CME, Kahn points out.

Kahn has also let Grassley’s staff know that his organization, CMSS, is in the process of developing a code on interactions between specialty societies and industry, and that code will reinforce the concept of transparency as a professional responsibility.