Did your doctor’s scrawl on the prescription pad reflect what was in your best interest as a patient? Or did payments to your physician by drug or device makers potentially influence this or other exam-room decisions?
Patients should be able to easily access the information about these financial ties to decide for themselves. In 2010, Congress agreed, passing the Physician Payment Sunshine Act to make public the legal and often-lucrative industry payments to physicians for promotional talks, consulting and research.
Unfortunately, lawmakers and the consumer advocates pushing for this important advance weren’t able to close a critical loophole in the federal law. It does not require disclosure of industry payments to advanced practice nurses and physician assistants, who also can write prescriptions and are increasingly relied on by patients and clinics.
New legislation introduced by Iowa Republican Sen. Charles Grassley, a champion of the 2010 law, and Connecticut Sen. Richard Blumenthal, a Democrat, merits broad support because it would sensibly close this loophole. Minnesota’s increasingly influential congressional delegation should give high-profile backing to this sensible legislation. The bill also has the support of the respected, nonpartisan Pew Charitable Trusts.
The amount of industry money flowing to physicians is staggering: $3.5 billion to 681,432 doctors nationwide from August 2013 to December 2014, according to an analysis by ProPublica, a nonprofit online news site.
New data from Minnesota, one of five states that has required disclosure of payments to advanced practice nurses and physician assistants, suggests that industry dollars flowing to these providers are also substantial. That underscores the need for the congressional fix to ensure that these data are reported across the nation.
An editorial writer’s analysis of Minnesota’s 2014 disclosure reports indicates that a total of $285,320 was paid to 42 nurse practitioners or physician assistants last year. The disclosure reports were filed with the Minnesota Board of Pharmacy.
That’s an average of $6,793. Some nurse practitioners were paid as little as $5.89, while some were paid much more. A clinical nurse specialist who provides mental health care received 33 payments totaling $73,310 from AstraZeneca Pharmaceuticals for “compensation and expenses for speaking.”
Another advanced practice registered nurse received one payment of $21,800 from Merck & Co. and another payment of $2,637 for “education” and “speaking or consulting fees.”
Pew’s Allan Coukell calls the Grassley-Blumenthal legislation “a logical step” that would “level the playing field” for all medical providers. The information shouldn’t be kept from patients. Congress should move swiftly to provide public access to all of it.