What Sunshine Act? Are Pa ments to Doctors b Com anies Undeterred?

A review of the payments to physicians posted on the CMS Open Payment website indicates that there has been no decrease in the payments to physicians by companies. In 2015, drug companies paid $7.52 billion just like the $7.49 billion paid last year to more than 600,000 physicians of almost all kinds of specializations. The list of top 10 companies paying physicians stayed mostly the same. A superficial overview of the information may show that the payments to physicians are unchanged and that the Sunshine Act is not effective in curbing payments to physicians. However, a careful review of the kind of payments indicates a different trend.  The most significant change from 2014 was the amount of contributions made to charity by companies on behalf of physicians. Charitable contributions are donations made by a company to a charity supported by a given physician. Technically, per the Sunshine Act, such donations to charity are considered as payments to that physician but the physician does not personally financially benefit from such donations. Such donations went up by 120%. Payments to physicians to act as faculty on non-accredited professional courses went up by about 25% while payments in the form of royalties or license fees went up by about 15% from last year. But practically all other forms of payments to physicians where a physician may get a direct monetary payment either stayed the same or were drastically reduced. Honorarium were reduced by 50%, gifts by 30%, payments for educational programs by 30%, entertainment by 20% and consulting fees by about 15%. So, it does seem that the Sunshine Act reporting is reducing overtly inappropriate payments to physicians while maintaining a relationship between physicians and companies. Concerns have been raised for all payments to physicians, even minor payments; however, a broad brush approach to paint all payments as suspicious is not fair. The intent of the Sunshine Act was to discourage overt bribing of physicians but not to ban all relationships between companies and prescribers of their products. We only have data for two years but it seems there are significant changes in the payment trends. Patients should be assured that the Sunshine Acts is working as intended.