A federal database to publicly disclose payments to physicians companies went live this week, drawing attention to a touch of $ 3.5 billion given to doctors over five months last year. Although one purpose of the site is to shed light on potential conflicts of interest in research, the site may fall short of this goal.
The origins of the database back to a survey by Charles Grassley Senator (R-IA) in drug company consulting by university researchers. From 08, employees have alleged that Grassley a dozen psychiatrists and others failed to fully disclose to their employers hundreds of thousands of dollars in consulting revenue they received from companies. Public Health Service (PHS) Policy for the National Institutes of Health (NIH) grants the necessary researchers describe these payments to their institutions; but the totals reported below those reported by companies Grassley. In some cases, payments were companies whose drugs, the researchers studied, Grassley alleged (see full frame of a former member of staff Grassley here).
The Institute of Medicine (IOM) recommended the wider communication of the potential financial interests, and in 2011, PHS responded to stricter rules. IOM has also approved a proposal Grassley to require companies to report payments for display in a public database. Besides revealing payments that could influence the decisions of a doctor's prescription, medical schools have said such a database could help to cross-check that their faculty (those MDs, anyway) report under PHS rules.
the Grassley proposal became part of the Affordable Care Act, 2010, and opened payments database, managed by the Centers for Medicare & Medicaid Services ( CMS), entered into on 30 September. For now, it contains 4.4 million payments reported by drug companies and doctors to 546,000 devices and 1,360 teaching hospitals from August 2013 December 2013. They will free trips, meals, fees language, and gifts in search of funding. The links "does not necessarily indicate wrongdoing" and may include "benefits" CMS said in a press release, but their disclosure may "discourag [e] inappropriate relationships"
Up. now open payments got a mixed response. the investigative journalism group ProPublica warns of incomplete data and funding for ongoing research can not be included. (in addition, about 40% of payments are anonymised because CMS has not yet been able to match them with a personal doctor.) the site contains a little more raw huge spreadsheets that are difficult to find. CMS has promised to better search tools soon .
other problems include the research data itself. for example, payments include the dollar value of drugs offered by companies for clinical trials. For some medicines for cancer and hepatitis C that cost upwards of $ 100,000 per year, the total dollar value for only a few patients could be "staggering," wrote several researchers from Johns Hopkins University in an editorial September 30 online in Annals of Internal Medicine . They say the public may not be aware that payments are drug donations, not money going to individual researchers.
There are also not yet clear that the database will be a great help for institutions to audit faculty reports, said Heather Pierce the Association of American Medical Colleges in Washington, DC In addition to that the data are incomplete and in 2013, the payments appear individually posts, while institutions normally ask the faculty for the total costs of a company. There will also be differences because companies can include the dollar value of expenses such as hotel and transportation for a silver engagement speaking researcher never sees.
"There are many potential problems that can cause confusion or misunderstanding on the side of research payments," said Pierce.
She said that concerns about these differences have deterred some institutions to follow up on a suggestion in the PHS rules that show consulting revenue line researchers. Many are instead releasing it only on request.
Meanwhile, Pierce said, even with incorrect data in open payments' means either there may be a point for starting conversations "about why clinical researchers interact with industry, which "can be a very positive thing."
* fixed October 3, 8 am :. drug costs are $ 100,000 per year, not one months
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