Impact of US Industry Payment Disclosure Laws on Payments to Surgeons: A Natural Experiment
As of August 2013, the Affordable Care Act of 2010 established the Open Payments program also known as the Physician Payment Sunshine Act. Pharmaceutical and medical device manufacturers had to start reporting nearly all payments to physicians and teaching hospitals to the Centers for Medicare & Medicaid Services (CMS). The goal of this legislation was to minimize the perceived undue influence of industry over the medical profession. Several reports, articles, and books raised concerns that the primary goals of medicine, defined as improving health by providing beneficial care to patients, conducting valid research, and offering excellent medical education, were in danger of being compromised by the undue pursuit of financial gain, academic honors, or other secondary interests posed by conflicts of interest.
One study that looked at payouts to ObGyns who were trained in pelvic medicine and reconstructive surgery found that median total payments have decreased each year following the legislation while yearly research payments have increased.
Another recent study took advantage of a legal settlement between the Department of Justice and companies that manufacture hip and knee implants (2007). Due to the timing of the settlement, orthopedic surgeons became a specialty where mandatory disclosure of any payment from industry was required prior to the Sunshine Act taking effect. In a natural experiment, i.e. an empirical or observational study where the control and experimental variables of interest are influenced by nature or factors outside of the researchers’ control and not artificially manipulated by researchers, the authors compared orthopedic surgeons with non-orthopedic surgeons from 2014 to 2017 (post enactment of the Sunshine Act). They hypothesized that if the Sunshine Act impacted payments, orthopedic surgeons would already have felt the impact on payments from industry prior to the Sunshine Act. Therefore, following the Sunshine Act, non-orthopedic physicians would see a greater drop in their payments following their initial exposure to the legislation. The hypothesis held true and orthopedic surgeons did have a lower number and amount of payments received from industry when compared to non-orthopedic surgeons (predominantly in the form of food and beverages). However, research payments remained unchanged. These results suggest that the potential for undue influence on prescribing medication and professional behavior may be declining but research dollars have generally remained stable.
This website (the “Website”) is a service made available by The ObG Project LLC, its partners, affiliates or subsidiaries (“Provider”). This Website provides general information related to the law and is designed to help users safely cope with their own legal needs. This website does not provide legal advice and Provider is not a law firm. None of our customer service representatives are lawyers and they also do not provide legal advice. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a lawyer if you want legal advice. No attorney-client or confidential relationship exists or will be formed between you and Provider or any of our representatives.
This website is not intended to be a source for legal advice, and thus the reader should not rely on any information provided in this website as such. Readers should not consider the information provided to be an invitation for an attorney-client relationship, and should always seek the advice of competent counsel in the reader’s home jurisdiction. Provider may provide links to third party websites. These links are provided only as a convenience. Linked websites are not reviewed, controlled or examined by Provider and Provider is not responsible for the information, advertising, products, resources or other materials, of any linked site or any link contained in a linked site. The inclusion of any link does not imply endorsement by Provider. In addition, please be aware that your use of any linked site is subject to the terms and conditions applicable to that site. Please direct any questions regarding linked sites to the webmaster of that site.
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan