Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

被引:6
作者
Horstman, Alyssa A. [1 ]
Niziol, Leslie M. [1 ]
Chimonas, Susan [2 ]
Lichter, Paul R. [1 ]
机构
[1] Univ Michigan, Dept Ophthalmol & Visual Sci, WK Kellogg Eye Ctr, Ann Arbor, MI 48109 USA
[2] Mem Sloan Kettering Canc Ctr, Ctr Hlth Policy & Outcomes, 1275 York Ave, New York, NY 10021 USA
关键词
CONFLICTS-OF-INTEREST; PAYMENTS; PATTERNS; GIFTS; US;
D O I
10.1001/jamaophthalmol.2019.0085
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
IMPORTANCE Beside the goal of increasing transparency to the public, disclosure policies and laws have been established with a goal to also reduce ethically questionable financial relationships between physicians and the medical industry. Data on these relationships should be reviewed to understand the association between these policies and laws and the attainment of reduced relationships. OBJECTIVE To assess whether disclosure policies and laws have been associated with a decrease in financial disclosure reporting by physicians. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study uses yearly data from 2008 through 2015 from the participants in the American Academy of Ophthalmology's Annual Meeting. Trends in financial disclosures over time were investigated for the association of disclosure policies and laws with potentially beneficial, as well as ethically questionable physician-industry ties. Linear regression models were used to estimate the annual change in financial disclosures and are reported with 95% CIs. EXPOSURES Disclosure policies and laws. MAIN OUTCOMES AND MEASURES The annual aggregate financial disclosures by type (ie, consultant, lecturer, employee, grant support, equity owner, patent holder). RESULTS Financial disclosures increased from 3966 in 2008 to 5266 in 2015 (P < .001). The number of disclosures reported in the categories consultant, equity owner, patents, and grant support all increased from 2008 to 2015 (consultant disclosures, 121 [95% CI, 88-155] per year; P < .001; equity owner disclosures, 32 [95% CI, 22-42] per year; P < .001; patent disclosures, 19 [95% CI, 13-26] per year; P < .001; grant support disclosures, 78 [95% CI, 48-107] per year; P < .001), while the employee and lecturer categories did not change significantly. The percentage of financial disclosures in the lecturer category decreased relative to the total (estimate, -1.1% [95% CI, -1.3% to -0.8%] per year; P < .001), owing to the number of financial disclosures for this category remaining stable while most other types increased. CONCLUSIONS AND RELEVANCE Disclosure was not associated with a chilling effect (decrease in financial disclosures associated with potentially beneficial physician-industry ties). Disclosure was associated with a possible disinfecting effect, whereby the percentage of ethically questionable disclosures (ie, lecturers) decreased, although the frequency remained stable. A permissive effect (physicians becoming more inclined to having industry relationships) was also observed. Thus, disclosure rules should be enhanced or alternative approaches to disclosure reconsidered to promote a decrease in ethically questionable relationships.
引用
收藏
页码:523 / 530
页数:8
相关论文
共 42 条
[21]   Characterizing the Relationship Between Free Drug Samples and Prescription Patterns for Acne Vulgaris and Rosacea [J].
Hurley, Michael P. ;
Stafford, Randall S. ;
Lane, Alfred T. .
JAMA DERMATOLOGY, 2014, 150 (05) :487-493
[22]  
Kassirer Jerome P., 2004, On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health
[23]   Conflict of interest in oncology publications A Survey of Disclosure Policies and Statements [J].
Kesselheim, Aaron S. ;
Lee, Joy L. ;
Avorn, Jerry ;
Servi, Amber ;
Shrank, William H. ;
Choudhry, Niteesh K. .
CANCER, 2012, 118 (01) :188-195
[24]   Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing [J].
Larkin, Ian ;
Ang, Desmond ;
Steinhart, Jonathan ;
Chao, Matthew ;
Patterson, Mark ;
Sah, Sunita ;
Wu, Tina ;
Schoenbaum, Michael ;
Hutchins, David ;
Brennan, Troyen ;
Loewenstein, George .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 317 (17) :1785-1795
[25]   Physician report of industry gifts and quality of care [J].
Lee, Doohee ;
Begley, Charles E. .
HEALTH CARE MANAGEMENT REVIEW, 2016, 41 (03) :275-283
[26]   Debunking myths in physician-industry conflicts of interest [J].
Lichter, Paul R. .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 2008, 146 (02) :159-171
[27]   Contact between Doctors and the Pharmaceutical Industry, Their Perceptions, and the Effects on Prescribing Habits [J].
Lieb, Klaus ;
Scheurich, Armin .
PLOS ONE, 2014, 9 (10)
[28]   What Is the Enemy in CME, Conflicts of Interest or Bias? [J].
Lo, Bernard ;
Ott, Chelsea .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 310 (10) :1019-1020
[29]   Forecast for the Physician Payment Sunshine Act: Partly to Mostly Cloudy? [J].
Morain, Stephanie R. ;
Flexner, Charles ;
Kass, Nancy E. ;
Sugarman, Jeremy .
ANNALS OF INTERNAL MEDICINE, 2014, 161 (12) :915-U110
[30]  
Ornstein C., 2016, Now there's proof: Docs who get company cash tend to prescribe more brand-name meds