Study Finds 'Sunshine' Laws Have Little Effect On Prescribing

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The Massachusetts 'gift ban,' barring drug- and device-makers from showering doctors with money and meals, was passed way back in 2008, but it remains a live controversy. The House, by my count, has now twice passed repeals of the ban, according to the State House News Service; and it sounds like last week, the Senate once again said no, no repeal, according to Health Care For All.

So I figure this new study just out from the Colorado School of Public Health and Harvard will serve as fodder in the ever-swirling debate. The headline: "New federal disclosure law will have little impact on drugs prescribed."

And my provincially slanted summary: Maine passed a law in 2004 that required that gifts to doctors be publicly disclosed (which the Massachusetts gift ban also does). Nearby New Hampshire and Rhode Island have not. The researchers compared prescribing of two types of drugs — statins and antidepressants — in which gifts seemed likely to influence doctors to prescribe more expensive brands. And they found extremely little difference made by the public disclosure laws.

Conclusion, from lead author Genevieve Pham-Kanter, Ph.D., an assistant professor at the Colorado School of Public Health and a research fellow at Harvard University and Massachusetts General Hospital: ""If the policymakers who passed these measures were hoping for a deterrent effect they may be disappointed."

(Of course, if you're a gift-ban backer, your conclusion may be: It's not enough to disclose; you have to ban...And the finding makes intuitive sense to me: Have you ever looked up your doctors' gifts? No? Me neither. So why should your doctor care if they're listed somewhere?)

More from the press release:


Using a wide variety of public data, they compared Maine, which enacted a disclosure law in 2004, with New Hampshire and Rhode Island, two demographically similar states without such laws. Then they compared West Virginia, which also passed its disclosure law in 2004, with Kentucky and Delaware which had none.

In Maine, the law was associated with a 0.8 percentage point reduction in the use of branded statins compared to New Hampshire, and a 5.3 percentage point reduction compared to Rhode Island. The researchers found little to no effect in West Virginia.

"Our results show that the disclosure laws in the two states we examined had a negligible to small effect on physicians switching from branded therapies to generics and no effect on reducing prescription costs," said Pham-Kanter.

She noted that despite the laws, accessing information about how much money a physician received from a pharmaceutical company is still difficult and opaque. Much of the information is not on-line yet.

"Transparency is important in its own right, but if deterring unnecessary, costly prescribing is a concern for policymakers, more direct action may be required," Pham-Kanter said.

The research was funded by the Edmond J. Safra Center for Ethics at Harvard University.

This program aired on May 30, 2012. The audio for this program is not available.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.