TRANSPARENCY AND THE PRESS
Comer also asked the docs about the recent Dollars for Docs reports published by nonprofit news organization ProPublica recently
and picked up by newspapers and other media outlets. Twelve pharma companies are already required to publicly publish their
physician spend by corporate integrity agreements; ProPublica took this information and aggregated it into a database that
made it easy for journalists and the public to track which companies have spent what on specific doctors. Will physicians
think twice about becoming paid speakers or participating in peer-to-peer programs once the Sunshine Act goes into effect
and every company is required to post this type of information? Has there been a "ProPublica/Dollars for Docs" effect in the
physician community, or a hesitancy to be seen by the public as an industry shill?
"Like others, doctors love positive press and hate negative press," said Bazzo. "If there's any perception that a doc is
a money grubber, that could kill a practice." He compared the situation to when his system created a policy six years ago
to not allow pharma sales reps on campus. "This split our people," he said. "Some thought their presence was improper because
we're a teaching institution. Others didn't." He sees the same scenario playing out when it comes to attending pharma-sponsored
meetings once the Sunshine Act goes fully into effect. Those who see nothing wrong with attending dinner meetings may still
attend, but "those who go to three or four pharma-sponsored dinner meetings per week may stand out."
While Choi said his organization doesn't have an overt ban, it is highly influenced by neighboring Stanford University Medical
Center, which six years ago instituted a policy that prohibits its physicians from accepting gifts or compensation from representatives
of pharmaceutical companies, medical device manufacturers, biotechnology companies, and medical supply companies. The ban
includes drug samples as well as pharma-sponsored dinners or lunches. "They can't accept even a pen from pharma," he said,
adding "We try to encourage all in our group to follow similar rules. Those who don't are not representing the organization."
When asked, "What would make you come to a promotional meeting?" Bazzo said that, since patient education materials are still
allowed, he would be more inclined to go to a non-CME meeting that included tools he could bring to his practice. While he
does not go to many non-CME events these days, Choi said he may make an exception if the activity covers a new method of practice
his colleagues at Stanford are using that he would like to learn more about.
"If I have limited time, a dinner meeting with no CME credit might not be so attractive," Bazzo added. But for physicians
who enjoy face-to-face interactions, "They will still come to dinner meetings," he predicted.
THINKING OUTSIDE THE LUNCH BOX
The pharma and medical device meeting managers in the audience had more than promotional luncheons or dinner meetings on their
minds. One asked, "What do you see for the future of investigator meetings? Will pharma companies have to look more outside
of the U.S. now that the Sunshine Act reporting rules may make more U.S. physicians wary of participating?"
Maybe, said Brazzo, adding that it would be bad for everyone if that were the case because "you would lose the U.S. perspective,
which is vital." While those who were wavering might drop out of the investigator pool, he predicted that there would always
be U.S. docs willing to participate in investigator meetings. "We'll see when the first wave goes out. Some people may drop
out, but that may level out as [the reporting process] becomes more normalized."
Will these new transparency rules dissuade docs from working on the clinical trials pharma companies need to get their drugs
through the Food and Drug Administration approval process? Kusske said he thought most would still be willing to participate
in studies sponsored by industry, as long as they could report all the results and as long as how the money was spent also
is transparent to the public, the way it is with National Institutes of Health grants. "I think that'll be a positive moving
forward," he said.