MedPAC calls for reporting of samples

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An influential advisory board urged Congress to impose far-reaching transparency rules on payments to healthcare professionals and organizations interacting with the drug industry—including reporting samples, in part to aid counterdetailing efforts.

The Medicare Payment Advisory Commission (MedPAC) delivered a much-anticipated report on Medicare payment policy Friday, essentially calling for a significantly expanded version of the Physician Payments Sunshine Act currently pending in Congress. The group, which functions as a kind of congressional think tank advising on Medicare policy, recommended that manufacturers of drugs, devices and biologics be required to report payments and transfers of value worth more than $100 per year including: gifts; food; travel; honoraria; research; funding for education and conferences; consulting fees; investment interests, royalties and samples.

“In 2005, pharmaceutical manufacturers provided free samples with a retail value of more than $18 billion to physicians and other providers,” the report's executive summary said. “While free samples may benefit the patient, there are concerns they may influence physicians' prescribing decisions and lead physicians and patients to rely on more expensive drugs when less expensive medications might be equally effective. More information about the distribution of samples would enable researchers to study their impact on prescribing patterns and overall drug costs and could help payers and health plans target their counterdetailing programs.”

MedPAC called for company reporting on gifts not just to physicians, but also to: “physician groups and other prescribers; pharmacies and pharmacists; health plans, pharmacy benefit managers and their employees; hospitals and medical schools; organizations that sponsor continuing medical education; patient organizations and professional organizations.”

Federal reporting requirements should carry broad pre-emption powers, the group advised, with exception to those state laws that mandate more information on payments and recipients than the US does, and the Secretary of Health and Human Services should be authorized to assess civil penalties on companies that fail to meet the law's requirements.

The report's recommendations largely echo those it voted to adopt at a November meeting.
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