Sunshine Act: Are Doctors Still Enjoying Free Lunches From Drug Reps?

Leigh Page

Disclosures

November 21, 2017

In This Article

Everything Gets Reported to the Public

The so-called Physician Payments Sunshine Act, enacted in 2010, will soon go into its eighth year. In 2013, pharmaceutical and medical device companies began tracking information on their interactions with physicians, and the Centers for Medicare & Medicaid Services (CMS) reports that information in a public database on its website.

Has anything changed over the years? Has the Sunshine Act made its desired impact, or has the initial furor died down?

Many doctors are still holding out against these changes. They are unhappy with the CMS website that reports industry payments made to them, and they are concerned about recent decisions by healthcare organizations, organized medicine, and even the drug and device industries to change time-honored relationships.

In Medscape's 2016 Ethics Survey Report, 62% of physicians said that they could be a paid speaker at pharmaceutical company dinners or accept lunches from drug reps without it influencing their prescribing habits.

Catered Lunches Have Been a Tradition

One focus of this debate is the longstanding tradition of sales reps ordering catered lunches for physicians. Of more than 8000 meals that reps ordered in 2015 through ezCater, an online ordering site, the most popular were burgers, sandwiches, Southern barbeque, and Mexican cuisine, according to a report[1] by the company.

Pizza was also on the list, although it accounted for just 17% of drug reps' orders. Iced tea was the chosen drink for 55% of orders, and 58% also included a dessert, all paid by industry. The average order for the office cost $150, and the average cost per person was $17, which means that these lunches feed 14-15 people at a time.

Physicians often insist on inviting their whole staff, even though the reps only want to talk to the physician. In an interview with a South Dakota newspaper,[2] a former drug rep recalled, "You would walk in and have to feed 30 people to talk to three people who needed the information."

Feeding even the whole office is, of course, just a drop in the bucket compared with the much higher payments that some doctors earn for giving speeches or consulting. But even the doctor's $17 meal has to be reported to the new Open Payments website, which is run by CMS.

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