A new study suggests that increased public awareness of the Open Payments system will diminish patient trust.
“An unintended consequence of the public disclosure of industry payments via Open Payments may have been diminished trust among American individuals in their physicians,” write Genevieve P. Kanter, PhD, of the University of Pennsylvania, Philadelphia, and her colleagues in an article published online April 12 in JAMA Network Open. This disclosure is likely to impact the entire industry regardless of whether certain physicians choose to accept financial support from drug manufacturers or medial suppliers, according to the study’s authors.
In a survey of 1388 U.S. adults that was conducted before the onset of the new system and after the launch of the federal Open Payments database, the article’s authors found a “2.7% decline in trust in one’s own physician, as assessed using the validated Wake Forest measure of trust.” This occurred despite the fact that many of the survey respondents’ doctors had not received industry payments.
“Therefore, public disclosure may have resulted in negative reputational spillovers affecting ‘pharma-free’ physicians and physicians with industry ties,” the authors state.
The Physician Payments Sunshine Act, which was included in the 2010 Patient Protection and Affordable Care Act, requires manufacturers of drugs, medical devices, biological, and medical supplies covered by federal health care programs Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS). The goal of the law is to increase the transparency of financial relationships between health care providers and pharmaceutical manufacturers and to uncover potential conflicts of interest. In 2013, the American Medical Association (AMA) offered physicians training to understand the Sunshine Act, and as part of the transparency sought, it mandated the creation of Open Payments database, which can be accessed by the public.
The Open Payments database is maintained by the Centers for Medicare & Medicaid Services and records payments to health care providers and ownership interests these providers have in medical device firms and pharmaceutical companies. It also gives an overview of food, travel, and accommodation costs paid by the parties of interest.
The results of two rounds of surveys were considered. The first round was conducted from September 26 to October 3, 2014. 90.5% were completed before September 30 when the Open Payments data was released to the public. The second round was conducted from September 16 to October 2, 2016. In the current analysis, the authors focused on “respondents who reported seeing the same physician in both the first and second waves.” They reported, “in addition to the decline in trust in one’s own physician, there was a 2.2% decline in trust in the medical profession as a whole.”
“First, we would have to assume that respondents even know that Open Payments exists; however, prior research shows that only 12% of U.S. adults are aware of the data,” the authors wrote. This means that the majority of adults in the United States aren’t even aware of the existence of this information. The authors contend that once word gets out, the added transparency will cause a decline in the public’s trust.