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Feature Conflicts of Interest

Two years of sunshine: has openness about payments reduced industry influence in healthcare?

BMJ 2016; 354 doi: (Published 25 August 2016) Cite this as: BMJ 2016;354:i4608
  1. Jeanne Lenzer, associate editor, The BMJ, USA
  1. jlenzer{at}

Two years since the implementation of the US law that requires industry to disclose payments to doctors, Jeanne Lenzer assesses its impact

The Physician Payments Sunshine Act, passed in March 2010, was heralded as a “watershed moment” that would expose physicians’ conflicts of interest to the “disinfecting effects” of sunlight.1 2 3 4

The act, intended to curb undue influence of drug and device makers over medical research and physicians’ prescribing habits, took effect in 2013, and industry payments to doctors were made publicly accessible through the Open Payments website of the Centers for Medicare and Medicaid Services (CMS) from September 2014.5 6 From the outset questions were raised: would doctors be less likely to take industry payments? If they did continue to take payments, would they be any less likely to prescribe brand name drugs when generics were available? Would patients question their doctors? Would the act reduce healthcare costs?2

According to the CMS, industry reported that it made 11.9 million payments totaling $7.52bn (€6.7bn; £5.8bn) to 618 931 physicians and 1116 teaching hospitals in 2015. Payments included $3.9bn for research; the remaining $3.6bn was for consultancies, speaker’s fees, and other financial considerations.

Exemptions and disputes

Twelve types of payments are exempt from reporting, such as payments for specific types of continuing medical education, receipt of product samples, and discounts and rebates.2 7 Gratuities valued at less than $10 do not have to be reported unless they reach $100 in …

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