Open Payments Database: Despite Criticism, Still On Track To Let The Sunshine In

Despite technical glitches, the federal “Open Payments” database – which tracks pharmaceutical company contributions to doctors and teaching hospitals – remains on track for its scheduled Sept. 30 launch, the Centers for Medicare and Medicaid Services confirmed.

It was mandated by a sunshine act included in the federal health law seeking to ease concerns that pharmaceutical interests could wield excessive influence over health providers. The database includes payments for research, gifts, meals or speaker fees. Consumer advocates have long called for the public display of such information, arguing that it is key to ensuring doctors don’t prescribe certain drugs out of financial incentives or loyalty.

As planned, the initial site will contain five months’ worth of payment information, spanning August 2013 through December 2013. But after a series of fits and starts, about one-third of the payment information for that period won’t be included because of questions that recently surfaced about its accuracy.

Here’s what happened. CMS made information about specific physicians and teaching hospitals available to those individual providers earlier this summer  so that they could confirm or contest payments and contributions listed. But at least one doctor saw payments that corresponded to a different provider, an error attributed to payment information that had been incorrectly submitted.

The mistake, found at the beginning of August, prompted an investigation by CMS that uncovered multiple inaccuracies, leading the agency to take down the database for more than a week. Since then, one third of the payment data included in the system has been removed, although a CMS spokesperson said corrected information will be reviewed and published next year. CMS would not specify what the flaws were with the removed information.

CMS has downplayed critics’ concerns that the problems indicate the database is not ready for public view and pledged  all data will be posted to the site in June 2015. The agency has suggested the inaccuracies come from incorrectly submitted drug company reports. Pharmaceutical interests, though, argue their companies submitted the data correctly – and that the fault lies in the technology behind the database.

ProPublica reported Aug. 28 that the database wouldn’t include payments pharmaceutical companies may have made to doctors through third-party organizations, because of potential inaccuracies. Pharmaceutical companies could have given payments to contract research organizations, for instance – which perform tasks such as clinical trials – but any payments those companies then made to doctors haven’t been appropriately reviewed by doctors, according to the news organization.

The American Medical Association, which has expressed a variety of issues with the Open Payments database, declined a request for an interview. But in an Aug. 5 letter to CMS, it requested the launch be delayed until March 31, 2015, arguing that unveiling the database on Sept. 30 doesn’t allow enough time for physicians to register in the database – which they say is an overly complicated and frustrating process — and verify the listed information, among other things. More recently, in a Sept. 3 Wall Street Journal interview, AMA President Robert Wah said the agency “supports transparency” but believes inaccuracies in the database could have unfairly damaging consequences for physicians.

The Pharmaceutical Research and Manufacturers of America – an organization representing many of the nation’s large drug-producing interests – has not taken a stance on whether the site’s launch should be postponed. But PhRMA is “really concerned” about the site launching without the complete set of payment information, said Lauren Roth, assistant general counsel.

“We are concerned primarily that when it is posted,” Roth said, “that it is posted with information that is accurate and properly reflects the contents of the payments.”

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