Starting September 30, 2014, the Centers for Medicare and Medicaid Services (CMS) made available to the public a database containing information about financial ties between doctors and hospitals and healthcare companies that sell to them, like device manufacturers or pharmaceutical companies. Part of the "Sunshine Act" under the Affordable Care Act, the database includes information about payments doctors and hospitals receive such as money for research, gifts, speakers' fees, travel, or meals from the healthcare industry.
The purpose of the database, officially named the CMS Open Payments System, is to allow healthcare consumers to learn whether their doctors receive such payments, and to decide for themselves if receipt of payments could constitute a conflict of interest regarding treatment.
Possible Benefits of CMS Open Payment System to Pharmaceuticals
It may appear at first that the purpose of the database is to shame doctors into refusing payments or products from manufacturers and pharmaceutical companies, and that it will have an immediate chilling effect on the relationships between pharmaceutical sales reps and doctors. This could certainly affect pharmaceutical sales training.
The database is still new, and not entirely functional, and with that, the effects so far have been minimal. In fact, the database could ultimately benefit life sciences companies, by allowing them to better track where they're spending money. There's no question that reporting requirements will have to become part of pharmaceutical sales training programs, but so far there's little evidence that the fundamental relationship between sales reps and doctors will change that much.
Will the System Discourage Industry Ties?
Some people worry that the database will discourage potentially beneficial industry ties. In fact, bipartisan legislation is being floated in Washington to exempt reporting requirements for educational materials like textbooks and scientific paper reprints, because these can directly benefit physician choices and patient outcomes.
The AMA says that just because a physician has a relationship with the medical industry does not necessarily mean he or she has compromised on professional judgment. In fact, doctors work with the industry to develop medical devices and design clinical trials. There is some worry that the medical industry will simply stop working with American doctors due to reporting requirements, but it's way too early to determine if that's realistic.
Do Patients Care if Their Doctors Received Payments?
One important factor potentially indicating that the database won't fundamentally change the doctor-industry relationship or have profound effects on pharmaceutical sales training is that patients apparently don't mind if their doctors have industry ties. This may be particularly true when the physicians disclose their involvement directly to patients. Some studies have suggested that "in a strange way it sometimes leads patients to have greater trust in the specialists," according to Trudo Lemmens of the University of Toronto.
An Early Study: Effects of CMS Open Payments Systems on Prescribing Behavior Minimal
Maine and West Virginia enacted their own Sunshine Laws before the ACA, and a study was published in the Journal of the American Medical Association in 2012 concerning the effects of the laws on prescribing behaviors. Researchers specifically studied prescribing of statins and selective serotonin reuptake inhibitors (SSRIs) because marketing plays an important role in these drug categories since they are "highly substitutable." Their hypothesis was that disclosure requirements would lead doctors to cut down on prescribing of branded statins and SSRIs.
Prescribing of branded vs. non-branded products were compared with prescription statistics for states without disclosure laws. Researchers found that overall, "there were negligible to small effects of the disclosure laws in Maine and West Virginia for both statins and SSRIs." This could be an encouraging sign that pharmaceutical sales training won't have to change significantly due to the CMS Open Payments System, aside from learning reporting requirements.
The Sunshine Act provision of the ACA is supposed to provide patients with transparency about medical industry payments to physicians. It's still very new, and many problems are in the process of getting ironed out. Moreover, further legislation could change what does and does not have to be reported. Right now it's too early to tell whether the database will have a major effect on relationships between doctors and industry, and therefore on pharmaceutical sales training.
Whatever the effects of the CMS Open Payments System has on pharmaceutical sales training, you can be certain that CLD will remain informed and on top of any changes. CLD is a leader in pharmaceutical sales training, remaining on the forward edge of technology, training techniques, and cost-efficiency so sales trainers can provide their sales teams with outstanding training that takes into account legislative and industry changes that affect their relationships with clients. Contact us if you'd like to learn more.