Editorials

Physician Payment Sunshine Act

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4828 (Published 01 August 2013) Cite this as: BMJ 2013;347:f4828
  1. José G Merino, US clinical research editor
  1. 1BMJ, Bethesda, MD 20814, USA
  1. jmerino{at}bmj.com

Some answers, many questions

Collaboration between practicing physicians and industry may result in the development of new drugs and devices. Physicians can identify unmet needs and provide crucial clinical and scientific input into trials. For these valuable services they should be reimbursed.

But interactions between physicians and industry more often deal with marketing rather than science: cash and in-kind gifts are offered to change physician’s prescribing patterns.1 These interactions may lead to conflicts of interest, with considerations other than patients’ interests affecting clinical decisions, and may also lead to higher healthcare costs.2 3 4 Even small gifts can lead to subtle changes in behavior, which is why many of us receive invitations to participate in educational activities or advisory panels, and why we receive free drug samples and visits from retailers.

A national physician survey in 2009, for example, found that 83% of physicians had interactions with industry (71% received food in the work place; 64% drug samples; 18% reimbursement for costs associated with attending professional meetings; and 14% money for consulting, lectures, and enrolling patients in clinical trials).3 Although the proportion of physicians interacting with industry has fallen since 2007, perhaps due to policies adopted by different professional bodies and academic institutions, such interactions persist.1 3 In Massachusetts, a state …

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