Eli Lilly, Merck to disclose payments to physicians

Legislation would create payments registry

(Editor's note: Look for continuing coverage of the Sunshine Act in future issues of Medical Ethics Advisor.)

More and more questionable ties between physicians and drug companies are being uncovered in an investigation into such financial relationships conducted by Sen. Charles Grassley (R-IA).

As those come to light, legislation called the Physicians Payment Sunshine Act has been proposed by Grassley, along with Sen. Herbert Kohl (D-WI). It was introduced in September 2007.

That legislation would create a national registry of payments to physicians by not only biopharmaceutical companies, but also medical device and medical supply companies.

In advance of passage of this legislation, two major drug companies, Eli Lilly & Co. and Merck, reported recently that they would disclose certain payments that they make to physicians.

Lilly says in a news release that it was the "first pharmaceutical company to endorse" the bipartisan, so-called Sunshine Act.

At a speech in late September before the Economic Club of Indiana, Lilly president and CEO, John Lechleiter, PhD, set forth the company's intention to launch an online registry of physician payments in 2009. In outlining the plan, Lechleiter said, that the company has ". . . learned that letting people see for themselves what we're doing is the best way to build trust."

Under the plan, an Internet database listing Lilly's payments to physicians will be made available to the public. The company expects to launch the registry "as early as the second half of 2009," it said.

Initially, the contents of the database will include 2009 payments to physicians who serve as speakers and advisors to the company. But Lilly says it expects that by 2011, the reporting capabilities of the database will "resemble the Sunshine Act legislation."

"Eli Lilly is leading the charge for transparency in the relationship between pharmaceutical companies and doctors by fulfilling the obligations of the Physician Payments Sunshine Act before it has been enacted," said Kohl, in a Lilly news release. "It takes a lot of courage to be the first. They have made a principled decision that I believe will benefit both their business and the consumers of their products."

Lilly also says that in 2004, the company marked another "first" by voluntarily making public its clinical trials and its clinical trials data. In 2007, Lilly says it also became the first to publicly report all of its educational grants and charitable contributions, which the company posts quarterly on a specific web site.

Merck, too, has endorsed the pending Sunshine Act, which will require disclosure of financial relationships with physicians.

"Even in the absence of a legislation requirement, however, we are committed to begin disclosure in 2009 of payments to physicians who speak on behalf of our company or our products," Merck says in a news release.

However, it maintains that "the engagement of the physician community with industry is in the best interests of patients and promotes information sharing and education about the newest medicines and treatments and patient experience."

Physician response to the Act

The American Medical Association in Chicago, as well as 20 other physician membership organizations, in June signed and sent a letter in support of the Physician Payments Sunshine Act — "as revised" — to both Sens. Grassley and Kohl.

"We believe that the Physician Payments Sunshine Act would establish a framework that allows patients, researchers, physicians, and others to obtain accurate and complete information on the nature of interactions between industry and physicians," the letter states. It notes that the legislation, as revised, will not only establish national reporting standards, but it also will allow "the opportunity for physicians to correct erroneous, false, or otherwise misleading information — so patients and others can reasonably rely on the quality of the reporting in the proposed public database."