Feature Competing Interests

Open Payments goes live with pharma to doctor fee data: first analysis

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6003 (Published 01 October 2014) Cite this as: BMJ 2014;349:g6003
  1. Duncan Jarvies, multimedia editor, The BMJ, London, UK,
  2. Rebecca Coombes, magazine editor, The BMJ, London, UK,
  3. Will Stahl-Timmins, data graphics designer, The BMJ, London, UK
  1. Correspondence to: D Jarvies djarvies{at}bmj.com

It’s just 24 hours since the Centers for Medicare and Medicaid Services (CMS) transparency database went live, detailing for the first time payments by US drug and device makers to doctors and teaching hospitals in the country. Open Payments (http://cms.gov/openpayments/) has already attracted 11 million hits. What the headline data show is that 4.4 million payments totaling $3.5bn (£2.2bn; €2.8bn) were made to more than 546 000 physicians and 1360 teaching hospitals in the last five months of 2013.

The collection and public release of those data is made possible by The Physician Payment Sunshine Act (PPSA). The data are free to access and fully searchable, and the CMS will update annually. So far the database shows only a partial view, covering payments made in the last five months of 2013. Going forward, the CMS will collect data from 1 January to 31 December, and release it the following June.

What kind of payments are reported?

The law demands disclosure of payments of more than $10 to doctors, other healthcare staff, and teaching hospitals for a range of activities. And it is a wide range. Consulting fees, speaker fees, honoraria, gifts such as promotional gadgets or vacations, and entertainment such as sports or concert tickets must all be declared. Also covered are food and drink, travel and hotels, textbooks, and research activity, including enrolling patients in clinical trials. The CMS also gathers data from companies on physician ownership or investment interests. So it is really talking about anything—there’s no such thing as a free lunch. You’ll also have to declare if you transfer that payment to a charity.

Here’s an example on the CMS site:

“A sales representative brings a catered lunch costing $165 to a 10-physician group practice. Six of the ten physicians and five support staff participate in the meal. Because the meal cost $15 …

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