As we’ve been noting for some time now, transparency efforts in the life sciences industry are here to stay. Within the last 48 hours, the UK has stepped up the game by announcing new rules for National Health Service (NHS) hospitals and General Practitioner groups (Policy & Medicine, Daily Mail). The so-called “Sunshine rule” will be introduced next year, and will require NHS organizations to maintain a list of the gifts and hospitality received by staff members from pharmaceutical and medical devices manufacturers.
According to UK Health Secretary Jeremy Hunt, “Only those serving their own self-interest should have anything to fear, with patients and taxpayers set to benefit.” Even the Association of the British Pharmaceutical Industry (ABPI) is on the record as supporting this new rule. But before we get caught up in “transparency fever,” perhaps we should step back, look at bit closer at the proposal, and examine some of the potential issues.
- Inconsistency: If the UK is maintains two lists, one for ABPI/EFPIA purposes and one for NHS purposes, there are bound to be inconsistencies when the lists are compared unless the reporting rules are absolutely identical. Our experience with Open Payments already illustrates the problem when you have one list; now imagine doubling the problem. Which leads directly into the second issue, cost reduction.
- Cost reduction: Although the UK believes this new measure will ultimately reduce costs and benefit taxpayers, experience to date with Open Payments and U.S. state reporting suggests otherwise. Administration and infrastructure costs to track, compile, report and maintain accuracy frequently are downplayed or completely overlooked by transparency advocates. While manufacturers and healthcare institutions likely do absorb some of these costs, ultimately it reaches a level that they must pass the costs on to the consumers (i.e., the taxpayers).
- Patient benefit: Like cost reduction, claims of patient benefit are dubious at best. Once again, experience to date has failed to reveal how transparency provides benefits to patients. In fact, there is evidence to suggest that even where patients know about a doctor’s receipt of gifts or hospitality, they don’t change their perceptions of the physician.
Don’t get me wrong, I am a proponent of transparency, but I think we need to carefully understand the costs versus the benefits of disclosure programs before creating new ones. No matter how much we wish it to be so, Sunshine is not the panacea that will solve the dilemma of rising healthcare costs and shrinking resources.