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. 2010 Feb;45(1):98-114.
doi: 10.1111/j.1475-6773.2009.01048.x. Epub 2009 Oct 13.

Show us the money: lessons in transparency from state pharmaceutical marketing disclosure laws

Susan Chimonas  1 , Natassia M Rozario, David J Rothman
Affiliations

Show us the money: lessons in transparency from state pharmaceutical marketing disclosure laws

Susan Chimonas et al. Health Serv Res. 2010 Feb.

Abstract

Objective: To assess legislation requiring drug companies to report gifts to providers, and to evaluate the information obtained.

Data sources: Data included legislation in Vermont, Minnesota, Maine, Massachusetts, West Virginia, and the District of Columbia, and company disclosure data from Vermont.

Study design: We evaluated the strengths and weaknesses of state legislation. We also analyzed 4 years of company disclosures from Vermont, assessing the value and distribution of industry-provider exchanges and identifying emerging trends in companies' practices.

Data collection methods: State legislation is publically available. We obtained Vermont's data through requests to the state's Attorney General's office.

Principal findings: Of the state laws, only Vermont's yielded robust, publically available data. These data show gifting was dominated by a few major corporations, and <2 percent of Vermont's prescribers received 69 percent of gifts and payments. Companies were especially generous to specialists in psychiatry, endocrinology/diabetes/metabolism, internal medicine, and neurology. Companies increasingly used loopholes in the law to avoid public scrutiny.

Conclusions: Disclosure laws are an important first step in bringing greater transparency to physician-industry relationships. But flaws and weaknesses limit the states' ability to render physician-industry exchanges fully transparent. Future efforts should build on these lessons to render physician-industry relationships fully transparent.

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Figures

Figure 1
Figure 1
Industry Payments to Vermont Physicians, Fiscal Year 2003–Fiscal Year 2006 Note. Payment types may be overlapping. Additional payment types (e.g., cash/check, donation/grant, consulting) appear in the data. This chart displays the five largest, by dollar value, appearing in all 4 years' reports. Sources: Vermont Attorney General's Office's Annual Reports.
Figure 2
Figure 2
Trends in Industry Payments to Top Specialties, Fiscal Year 2004–Fiscal Year 2006 Sources: Vermont Attorney General's Office's Annual Reports and Non-trade-Secret Data.
Figure 3
Figure 3
Prevalence of Trade Secrets, Fiscal Year 2003–Fiscal Year 2006 Sources: Vermont Attorney General's Office's Annual Reports and Non-trade-Secret Data.
Figure 4
Figure 4
Use of Trade Secrets Provision, by Company Rank, Fiscal Year 2003–Fiscal Year 2006 Sources: Vermont Attorney General's Office's Annual Reports and Non-trade-Secret Data.
See this image and copyright information in PMC

References

    1. Association of American Medical Colleges. “Industry Funding of Medical Education” [accessed on November 21, 2008]. Available at https://services.aamc.org/Publications/showfile.cfm?file=version114.pdf&....
    1. Brennan TA, Rothman DJ, Blank L, Blumenthal D, Chimonas SC, Cohen JJ, Goldman J, Kassirer JP, Kimball H, Naughton J, Smelser N. Health Industry Practices that Create Conflicts of Interest. Journal of the American Medical Association. 2006;295:429–33. - PubMed
    1. District of Columbia Municipal Regulations. “Prescription Drug Marketing Costs, Chapter 18, Title 22” [accessed on December 2, 2008]. Available at http://hrla.doh.dc.gov/hrla/lib/hrla/pharmacy_control/chapter.18.accessr....
    1. Earl R, Pride W. Do Disclosure Attempts Influence Claim Believability and Perceived Advertiser Credibility? Journal of the Academy of Marketing Science. 1984;12(1–2):23–37.
    1. Harris G. “Psychiatrists Top List in Drug Maker Gifts.”The New York Times, 27 June.

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