Towards Patient-Centered Conflicts of Interest Policy

Abstract

Financial conflicts of interest exist between industry and physicians, and these relationships have the power to influence physicians’ medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians’ reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS) launched the Open Payments Program (OPP) to publicly disclose and bring transparency to the relationships between industry and physicians in the United States. We set out to explore user awareness of the database and the ease of accessibility to disclosed information, however, as we show, both awareness and actual use are very low. Two practical policies can greatly enhance its intended function and help alleviate ethical tension. The first is to provide data for individual physicians not merely in absolute terms, but in meaningful context, that is, in relation to the zip code, city, and state averages. The second increases access to the OPP dataset by adding hyperlinks from physicians’ professional websites directly to their Open Payments disclosure pages. These changes considerably improve transparency and the utility of available data, and can furthermore enhance professionalism and accountability by encouraging physicians to reflect more actively on their own practices.

US Nationwide Disclosure of Industry Payments and Public Trust in Physicians

“…Less than 5% of US adults report knowing about their physicians’ industry payments or using the Open Payments website. 7 , 8 These findings are consistent with evaluations of other transparency initiatives in medicine (eg, the public reporting of hospital and physician quality), showing that patients are largely unaware of and rarely use the information disclosed. 9 …”

Effect of the public disclosure of industry payments information on patients: results from a population-based natural experiment

“…Two years after the Open Payments release, 13% of respondents knew that industry payments information about their physicians was available, and only 3% of respondents knew whether their doctor had received payments. These findings, together with findings from an earlier study showing that 1.5% of survey respondents had used the Open Payments database,20 suggest that Open Payments has fallen well short of its aspiration to better inform patients of their physicians’ industry relationships.…”

Pharmaceutical Sales Representatives in the United States and China: The Need for Professional Public Space

“…From the perspective of patients and the public, disclosure of payments affected their trust in physicians [50,51]. They supported the disclosure of physician-industry interaction [28], but only a few Americans reported knowing or using the Open Payments website [124,52].…”