According to a recent survey, some physicians actually know less about the Sunshine Act provision of the Patient Protection and Affordable Health Care Act now than they did one year ago. More than half of the 1,025 physicians surveyed in January by global communications technology company MMIS Inc. and healthcare information services company Health Data Solutions said they didn’t know that the law requires pharmaceutical and medical device companies to track any payments or “transfers of value” to physicians and teaching hospitals as of August 1, 2013.
They also didn’t know that the companies then will submit the data to the government, or that the Centers for Medicare and Medicaid will begin publicly reporting the data as of March 2014. This reflects a 5 percent decrease overall in familiarity with the law over last year’s survey results. This is the third year the survey was conducted.
Once they became aware of the Sunshine Act via the survey, 63 percent of the physicians surveyed said the Sunshine Act’s requirements—which aim to make the relationships between physicians and pharmaceutical and medical device companies more transparent—deeply concern them, in part because they don’t trust companies to get the information right.
The survey found that 94 percent want to be able to review the payment data before it goes public, and to dispute any claims they think are wrong, something the final rules do allow. Forty-three percent said inaccurate reporting would adversely affect their interactions with industry, and more than one-fifth said they’d sever their relationship with a company that reported incorrect information.
And many do report having some sort of financial relationship with industry, whether it be receiving samples (54 percent), receiving food and beverage in their workplace (57 percent), participating in an "industry-funded program" (48 percent), or participating in speakers bureau programs (11 percent) and advisory board programs (10 percent). Even though companies are prohibited from offering any entertainment or gifts that do not advance disease or treatment education under the voluntary Pharmaceutical Research and Manufacturers of America’s Code on Interactions with Healthcare Professionals—a practice that is also banned by law in several states—2 percent said they still accept free event tickets or gifts.
What About CME?
While the survey didn’t specifically break out questions about accredited or certified continuing medical education, non-certified CME, and promotional activities, it did ask respondents if they believed educational materials provided for patient education and industry support of conferences would fall under the Sunshine reporting rules. Thirty-nine percent thought that patient-education materials would have to be reported, and 75 percent thought that “conference funding” would also have to be reported.
This is actually a tricky question, because, while accredited CME activities have basically been excluded from the tracking and reporting requirements of the Sunshine Act under the final rule, which was released February 1, at present it appears that honoraria, meal and travel costs, and other activity-related costs for commercially supported non-accredited and promotional activities will be reportable, as will educational materials that do not directly benefit patients.
As MMIS CEO Michaeline Daboul says, the survey results indicate that “there are some misunderstandings out there. Physicians need to know that [accredited] CME will not be reported.” She adds that, if physician associations and specialty societies don’t take up the mission to educate docs about the Sunshine Act requirements, CME providers may have to take on the job, because misunderstandings about what will be publicly report could have potential repercussions on providers, even accredited providers.
She has a point. In another survey that was conducted in the fall of 2012 by the CME Coalition, a lobbying group for the CME community, while 95 percent of the docs said CME was moderately to very important to their ability to keep up with the latest in patient treatments, three-quarters of them said that, if the Sunshine Act’s reporting requirements included accredited, commercially supported CME, it would have some effect on their decision to participate in certified CME activities produced with funding from industry grants. Even though this is not the case, if they believe it is, they may well act accordingly.