Intended for healthcare professionals

Feature Affordable Care Act

Everything you need to know about the Sunshine Act

BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f4704
  1. Ed Silverman, editor
  1. 1Pharmalot, Milburn, NJ, USA
  1. pharmalot{at}

With the Sunshine Act coming into force from 1 August, Ed Silverman spells out exactly how physicians should respond

If you are a physician working in the United States, 1 August marks a watershed moment. This is when the Physician Payments Sunshine Act, which is part of the Affordable Care Act, goes into effect and is eventually expected to usher in a new era of transparency regarding the financial relationships between doctors and the makers of drugs and devices.1

The law is an outgrowth of a controversy over undisclosed payments made to physicians for things such as consulting and speaking fees, meals, gifts, and research funding. The widely debated topic prompted a US Senate probe in response to concerns that such financial dealings could unduly influence medical practice and research. Even small financial ties have been shown in various studies to bias physicians.

And so, drug and device makers must now collect and disclose payments exceeding $10 (£6.5; €7.6) to physicians and teaching hospitals and, starting in September 2014, the data will be posted on a publicly accessible website that will be administered by the Centers for Medicare & Medicaid Services. The data must also include all ownership or investment interests held by a doctor or family member.

For physicians, much is at stake. For the first time, patients will now be able to see what, if any, financial ties their own doctor has with a drug or device maker. As American Medical Association president Ardis Hoven notes, this affects “all physicians with a current medical licence.” To what extent this knowledge will sway patient decisions remains unknown, but the public database is predicted to generate a level of scrutiny that has never before been a part of the sacrosanct relationship between physicians and their patients.

“There are reputational …

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