Impact of Gift-Disclosure Legislation
Over the last few years, scrutiny of pharmaceutical promotion and gifts to practitioners has intensified; in response, some
states have required the reporting of physician gifts from drug and medical device companies. In addition, the Physician Payment
Sunshine Act was passed as part of the larger healthcare reform legislation in May 2010. The Sunshine Act requires pharmaceutical
and medical device manufacturers to disclose payments made to physicians. While the federal law does not supersede existing
state laws, it requires disclosure of individual payments of $10 or more or aggregate payments to a physician of $100 or more
in a given year. This disclosure is made to the Department of Health and Human Services, with the names of companies and physicians
posted on a public website.
Currently six states have gift-disclosure laws, with the minimum reporting value ranging from $10 to $100. The 2009-2010 legislative
sessions saw 11 additional states propose laws or regulations relating to gift disclosure or bans. In response to the pending
legislation and reality of public disclosure of this information, both the American Medical Association and the Pharmaceutical
Research and Manufacturers of America (PhRMA) have instituted voluntary guidelines advising physicians not to accept, and
companies not to provide, gifts in excess of $100, and that all gifts should be educational.
Figure 2: Percent of Events Offering Honoraria
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Historically, it wasn't uncommon for physicians (and in some cases their families) to be taken to luxurious meeting places
and restaurants for events as well as receive gifts for their attendance. When PhRMA issued gift-giving guidelines in the
early 2000s, major shifts in honoraria and event locations took place. Subsequently, there have been some noticeable changes
in the characteristics of events and physician participation.
Figure 3: How Gift Disclosure Regulations Have Affected Physicians’ Attendance at Meetings – July 2010
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The percentage of events where no honorarium/incentive was offered increased from about 5 percent in the 12 months ended May
2006 to more than 20 percent in the 12 months ended May 2010. Even presentation of meals/food declined from 77 percent to
66 percent of events over the same period (see Figure 2).
Figure 4: Online Event Growth
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So, how do these new regulations affect doctors? In a recent SDI poll of 300 physicians, more than half reported that there
has been no change in their event attendance, while 40 percent reported that they have decreased their attendance as a result
of gift-disclosure regulations (see Figure 4).
Online Events Growing
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With the hurdles imposed by gift-giving restrictions, along with the stormy economic climate, pharmaceutical companies increasingly
have turned to a more cost-effective approach: online events (see sidebar). Expect the industry to continue to adapt, as
the impact of healthcare reform grows clearer.
Who's Sponsoring Online Then?
Interestingly, the top sponsors of online meetings differ from those supporting in-person events. In the 12 months ended May
2010, Pfizer held the most online events, followed by Merck, Shire, GlaxoSmithKline, and Forest. Pfizer has dramatically increased
its focus in this area over the last few years. Compared with the 12 months ended May 2009, Pfizer online events rose 60 percent.
Merck has been one of the trailblazers in e-promotion over the last few years but has decreased its participation in the most
recent 12 months. Online events sponsored by Merck fell 22 percent in the year ended May 2010. Shire, GlaxoSmithKline, and
Forest all increased their e-promotion activity with 35 percent, 6 percent, and 68 percent more online events, respectively,
in the 12 months ended May 2010.
The most-promoted pro- duct online was Merck's Singulair, with just over 13,000 events. Shire's Vyvanse followed with almost
12,000. Pfizer's Pristiq, Merck's Januvia, and Pfizer's Celebrex completed the top five drugs promoted through online events.
Kelly Sborlini is Vice President, SDI, Audits & Media Innovations. She can be reached at ksborlini@sdihealth.com
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