Eli Lilly & Co. says it will begin disclosing how much money it paid individual doctors nationally for advice, speeches and other services.The drug company's move, believed to be an industry first, comes as members of Congress push a disclosure bill in an effort to prevent such payments from improperly influencing medical decisions and to prevent pharmaceutical fraud .
Beginning next year, Eli Lilly will disclose payments of more than $500 to doctors for their roles as advisers and for speaking at educational seminars. In later years, the company will expand the types of payments disclosed to include such things as travel, entertainment and gifts.
Some have voiced concerns that doctors are influenced by these payments in their treatment decisions and that this in turn can drive up medical bills. Although many physicians believe free lunches or trips have no effect on their medical judgment, research has shown these types of payments can affect how people act.
"The ethical handwriting is on the wall. Disclosure is coming. States are pushing for it, and once a few states do, it's hard to imagine the federal government won't line up behind," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.
Eli Lilly was also early in the industry on publicly reporting its educational grants for medical conferences. John Lechleiter, president and chief executive of the company, said that made good business sense for the drug industry.
"We've learned that letting people see for themselves what we're doing is a good way to restore trust," Dr. Lechleiter said.
In the past two years, lawmakers from both chambers of Congress have introduced bills that would require drug and medical-device manufacturers to disclose any payments to doctors exceeding $25, but the industry chafed at the strict reporting threshold. Eli Lilly had announced earlier that it intended to comply with key aspects of the legislation once some lawmakers in the Senate agreed to a higher reporting threshold of $500.
Scores of trade groups representing doctors, such as the American Medical Association, voiced their support for the legislation once it included the higher, $500 threshold. In a letter to lawmakers, the groups said the disclosures would "enhance the medical profession's ability to provide oversight and strengthen our ability to serve as stewards of medicine."
Eli Lilly's disclosure of payments to doctors will begin in the second half of 2009, and will cover payments made in the first half of the year. The company doesn't plan to report payments from 2008 or earlier, noting that the legislation before Congress also did not contemplate such a look back. Gradually, the company plans to expand its registry to incorporate all payments that the Physician Payment Sunshine Act would require be made public.
Wall Street Journal; September 24, 2008
