Mandatory Disclosure: Theory and Evidence from Industry-Physician Relationships

Abstract

The interaction of disclosure laws and the targeted behavior is typically unknown since data on disclosed activity rarely exist in the absence of disclosure laws. We exploit data from legal settlements disclosing $316 million in pharmaceutical company payments to 316,622 physicians across the U.S. from 2009-2011. States were classified as having strong, weak, or no disclosure based on whether data were reported only to state authorities (weak) or were publicly available (strong). Strong disclosure law was associated with reduced payments among doctors accepting less than $100 and increased payments among doctors accepting greater than $100. Weak disclosure states, despite imposing administrative compliance costs to industry, were indistinguishable from no disclosure states. This result suggests that the primary mechanism for fewer small payments in strong disclosure states was physicians' reduced willingness to accept payments rather than the imposition of significant administrative costs on industry. We conduct additional analysis holding fixed the cost for pharmaceutical companies of disclosing data, which was possible because Massachusetts began releasing payment data online during our sample period. Differences-in-differences analyses and multiple regression yield similar estimates for each payment category: Mandatory disclosure reduced payments for speaking and for meals but increased payments for consulting activities. Differences-in-discontinuities in distribution of payments at the disclosure threshold among strong and weak disclosure states support the interpretation of physicians' reduced willingness to accept payments. Significant disclosure aversion reducing conflicts of interest is consistent with the policy goals of mandatory disclosure, though the increased payments among those receiving large payments may have been unintended.

Who gains and who loses from more information in technology markets? Evidence from the Sunshine Act

“…Anecdotal evidence suggests that the improvement in the information environment determined by the Sunshine Act raised reputation concerns among physicians (Sullivan, 2018a). Indeed, physicians generally “regarded the Physician Payment Sunshine Act as a personal and professional threat to privacy and reputation” (Chimonas et al, 2017, p. 9), whereas “critics of disclosure suggest that these laws stigmatize physicians who maintain collaborative relationships with industry” (Chen et al, 2019, p. 441). Sullivan (2018c) documents two cases of physicians who disclosed that they are taking measures to avoid appearing on the database.…”