Healthy Skepticism Library item: 14355

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Publication type: news

Steinman M.
Eli Lilly Will Begin Disclosing Payments Exceeding $500 Made to Individual Physicians
Kaiser Daily Health Policy Report 2008 Sep 24

Full text:

Eli Lilly next year will become the first drugmaker to voluntarily disclose all payments more than $500 made to individual physicians for advice, speeches and other services, CongressDaily reports (CongressDaily, 9/24). Lilly eventually will disclose payments to physicians for travel, entertainment and gifts. The drugmaker was also the first to disclose its educational grants for medical conferences.

The disclosure will begin in the second half of 2009 and will include payments made during the first half of 2009. Lilly does not plan to disclose information on payments made before 2009. The payments will be listed on a public Web site, which will be available to the public at no cost (Freking, AP/Kansas City Star , 9/23). The information likely will include physicians’ names and hometowns, according to the Indianapolis Star (Swiatek, Indianapolis Star, 9/24). Lilly plans to update the information annually (AP/Kansas City Star, 9/23).

Lilly in 2011 plans to begin disclosing payments made for clinical research and other provisions called for in the Physician Payments Sunshine Act (HR 5605 , S 2029 ), which currently is pending in Congress (Indianapolis Star, 9/24).

Comments
John Lechleiter, president and CEO of Lilly, said that voluntary disclosure “is a good way to restore trust” among the public (AP/Kansas City Star, 9/23). Lechleiter said, “Lilly is striving to be a leader in improving transparency across our industry,” adding, “As Lilly continues to look for more ways to be open and transparent about our business, we’ve learned that letting people see for themselves what we’re doing is the best way to build trust” (Indianapolis Star, 9/24). He added that these payments are necessary because physicians are being compensated for their time, which otherwise could be spent treating patients, for which they would be paid. He said, “We’re oftentimes taking them away from their practice for a day or more,” adding, “It’s a service that they’re providing and they deserve compensation for that.”

Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said, “The ethical handwriting is on the wall. Disclosure is coming. States are pushing for it, and once a few states do, it’s hard to imagine the federal government won’t line up behind,” adding, “I think that’s a good thing because we have a great deal of empirical evidence that gift giving can influence behavior in terms of prescriptions, publishing positive findings but suppressing negative findings, and generating enthusiasm for new drugs.”

Reaction
Peter Lurie, deputy director of the Health Research Group at Public Citizen, said he was skeptical that Lilly’s move would increase transparency because it is only one company. He added, “This is Ely Lilly’s attempt to forestall the federal legislation by saying we’re in effect complying anyway.” According to Lurie, drugmakers should disclose all payments over $25, adding that the $500 threshold was too high.

Sen. Chuck Grassley (R-Iowa), sponsor of the Sunshine bill, applauded the announcement but said he will continue to push for legislation requiring disclosure. He said, “Consumers and taxpayers deserve a federal requirement that applies to all kinds of payments to physicians in every state in the nation” (AP/Kansas City Star, 9/23).

Senate Special Committee on Aging Chair Herb Kohl (D-Wis.), a co-sponsor of the Sunshine bill, in a statement said, “It takes a lot of courage to be the first. They have made a principled decision that I believe will benefit both their business and the consumers of their products” (Young, The Hill , 9/24).