The American Medical Association will evaluate mandatory disclosure of financial relationships between physicians and the pharmaceutical industry during the group's June 14-18 House of Delegates meeting in Chicago.

The House of Delegates establishes AMA policy positions that guide lobbying on legislative and regulatory matters.

The California delegation is proposing a resolution that calls for annual reporting by drug and medical device companies of all payments to physicians with a value of more than $100. Product samples for patients and meals provided in conjunction with educational meetings would be exempted. The resolution is silent on whether the reporting should be to a state or federal government agency.

The resolution cites incentives for off-label prescribing, lessened public confidence in physicians, and existence of state reporting laws as part of the rationale for the proposed policy.

In addition, the delegates have before them a resolution from the Missouri delegation calling on AMA to work with the Accreditation Council for Continuing Medical Education to develop more specific criteria for disclosing relationships between continuing education providers and commercial interests. AMA's Council on Medical Education has recommended an alternative resolution that directs AMA to monitor implementation of ACCME's standards for commercial support of CME.

AMA's debate is timely, as supporters of mandatory reporting on the national level continue to press for its enactment by Congress. Last year, AMA declined to take a position on the issue in Senate hearings because members had not discussed it.

The Pharmaceutical Research and Manufacturers of America and some individual drug companies signed on to a revised version of the Physicians Payment Sunshine Act, S. 2029, developed by Sens. Herb Kohl., D-Wis., and Chuck Grassley, R-Iowa (¹ Also see "Sunshine Bill Gains Momentum From PhRMA But Time May Be Running Short" - Pink Sheet, 26 May, 2008., p. 17). It would set up a national reporting registry of physician gifts and payments.

Grassley had said he would try to add the measure to a "must-pass" Medicare physician package, but it appeared in neither his nor the Democratic versions of that bill (² Also see "Grassley, Kohl Retool Physician Gift Reporting Bill To Defuse Opposition" - Pink Sheet, 19 May, 2008., p. 3). There was some speculation it would be brought up as an amendment during Senate floor debate. In any case, senators are back to the drawing board on the Medicare package, as they declined to allow it to move to a floor vote (see ³ Also see "E-Rx, Dialysis Bundling Are Likely Survivors Of Failed Medicare Doc Fix Bill" - Pink Sheet, 16 June, 2008.).

Lilly, which endorsed the revised sunshine measure in May, says it still is "hopeful that bi-partisan action will lead to inclusion of the Sunshine Act in the Medicare legislation."

Consumers Union would like to see a strong bill passed this year, the group's Steven Findlay said in an interview, noting that a coalition of consumer groups is seeking further changes to the revised S. 2029. Those changes include a clarification that the federal law would pre-empt only state reporting laws, not those that also ban company gifts to doctors, and a requirement for companies to report the total amount they pay to physicians.

- Cathy Dombrowski (c.dombrowski@elsevier.com)

AMA Delegates To Debate Gift Reporting; Sunshine Bill Still Has Ray Of Hope

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