A Cloudy Future for the Sunshine Act

Sun icon isolated on white vectorThe due date for posting another year’s worth of Physician Payment  Sunshine Act (a.k.a. Open Payments) data is fast approaching.  But the future for the Sunshine Act is cloudy.  A new Republican President combined with a recent academic study cast doubt on the Act’s future.

Sunshine & the Affordable Care Act

The Sunshine Act is part of the Affordable Care Act (“ACA”). Repealing the ACA is the top priority for Republicans. The new President also wants to trim regulations to support business.

The drug and device industry is no friend of Open Payments.  Tracking meals and other payments to doctors takes a lot of time and is expensive.  While some academics think that anything provided to physicians is bribery, the industry, and others counter that it’s absurd to think that a doctor would hurt the patient because he received a meal.  The industry also argues that patients don’t really care about payments to doctors.  Therefore, it seems likely that the sunshine will be eclipsed by the repeal.

The Drexel Study

A recent Drexel University study suggests the industry view may be right.[1]  The study found that almost 65% of the patients surveyed saw doctors who received payments from the industry.  Of those patients, only 5% knew their doctors got paid by drug or device companies.  This suggests that despite efforts to spread the word about Open Payments, patients either aren’t paying attention or don’t care.  It is a conclusion that others, including Pro Publica, have drawn before.

In addition, the average amount of money spent on these doctors was $510 over the course of a year. While it is higher than the overall average for all physicians ($193 vs. $510), it’s silly to think that a doctor would risk the future and his or her patient for such a small amount.

So Now What?

Although no one knows if the Sunshine Act will survive an ACA repeal, it seems plausible that it will get forgotten as the debate heats up around things like mandates and subsidies.  The industry, however, should be careful about celebrating Sunshine’s demise as it likely will result in new, uncoordinated state efforts. For those who can remember life before the Sunshine Act, having numerous state laws to deal with was more difficult. Finally, although Drexel’s Genevieve Pham-Kanter states she’s sure “there has been a lot of useful information — for patients, policy makers and researchers — that has come out about the scope and scale of these payments and how they might influence doctors, and I’m sure there’s much more to learn,”  her own study casts doubt on that conclusion.


[1] Science Blog, Two-thirds of Americans see docs who got paid by drug companies: Drexel University study, at http://bit.ly/2mmSFgh (Mar. 6, 2017).