Making Transparency Matter

 
Making Transparency Matter:  The Physician Payments Sunshine Act 

IMAP and Columbia University’s Center on Medicine as a Profession (CMAP) conducted a two-year research project to investigate the impact and significance of the Physician Payments Sunshine Act (PPSA).  Signed into law in 2010 as part of the Affordable Care Act, PPSA requires pharmaceutical, medical device, and other healthcare product manufacturers to disclose nearly all payments to physicians and teaching hospitals; the Centers for Medicare & Medicaid Services (CMS) annually collects, aggregates, and posts the data on a public website (https://openpaymentsdata.cms.gov/).  

PPSA is an extraordinary experiment in transparency:  Comprehensive data about physicians’ and medical institutions’ financial ties to industry are now a matter of public record, allowing us to ask – and finally answer – crucial questions about these ties. PPSA also has the potential to usher in far more effective procedures for controlling COI and promoting rational prescribing.  Many stakeholders – foremost among them academic medical centers (AMCs), teaching hospitals, medical journals, and professional medical associations (PMAs) – have critical roles to play in achieving these ends, but to do so they must leverage the opportunities Sunshine affords.   Given these high stakes, PPSA must be closely followed, its strengths utilized and its weaknesses addressed.

Hence, the focus of our project was twofold:  First, to investigate the extent to which PPSA and the Open Payments website make the data accessible and meaningful to patients and other users;  and second, to identify ways in which medical stakeholders can leverage the data so as to eliminate undue industry influence on prescribers.  

We used multiple methods to explore these issues, including focus groups with physicians, interviews with medical stakeholders, and website usability testing with consumers, physicians, and experts.  The findings informed the following open-access resources:

  1. Let the Sun Shine: Using Open Payments to Manage Conflicts of Interest - Best Practice Recommendations for Academic Medical Centers, Teaching Hospitals, Professional Medical Associations, Medical Journals and other Stakeholders
  2. Making Transparency Matter: Policy Analysis and Technical Recommendations for the Physician Payments Sunshine ActProposals for making PPSA and Open Payments more effective.
  3. Open Payments Evaluation: Usability and Usefulness of the Open Payments WebsiteAssessments by Physicians, Consumers, and Usability Experts
  4. Examining Open Payments: Usability, Usefulness and UnderstandingA Powerpoint Presentation on the Usability of Open Payments

These materials were also made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin.

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