MedPac, the congressional advisory commission on Medicare, has endorsed stringent transparency rules for drug, device and biologics manufacturers, including detailed reporting on drug samples with the aim of facilitating targeted counter-detailing.
The commission voted Thursday to recommend that Congress require manufacturers to report financial relationships with: “Physicians, 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” and patient and professional organizations.
Under MedPac's proposal, companies would be required to submit information on their relationships to the Secretary of the Department of Health and Human Services, who would post it online in a format searchable by manufacturer, recipient name, location and specialty, type of payment, name of the relevant drug or device and year.
In addition, manufacturers and distributors of drugs would be required to report the name and business address of each recipient of samples, along with the name, dosage and number of units of each sample and the date of distribution.
All hospitals and other entities that bill Medicare for services would be required to issue annual reports on physician ownership of interest in non-publicly traded hospitals and practices, and the HHS Secretary would be required to submit a report on the types and prevalence of financial arrangements between hospitals and physicians.
Tom Sullivan, president of med ed firm Rockpointe and proprietor of the Policy and Medicine blog
, noted the heavy managed care representation on the committee, and said managed care is looking to squeeze doctors and drug companies to save its skin. “Payers are anxious to gain access to this information for negotiation purposes, to help drive down the cost of healthcare,” said Sullivan. “With this information, they would have a treasure trove of data and they would be able to counter-detail.”
At last week's meeting, commissioner John Bertko, a former chief actuary at Humana who is now a visiting scholar at the Brookings Institute and adjunct staff at the RAND Corp. think tank, said, with respect to the provision on reporting of sampling: “I think it could still be useful in the sense that if you're looking for counter-detailing, a [pharmacy benefit manager] or [prescription drug plan] would know who the paid scripts were for, and they could look backward and see where the samples went and generated the paid scripts and know that that's the time to do the counter-detailing. So it would be kind of a retrospective look at these things, and it would be useful.”