Open Payments Having an Adverse Effect on Physician-Rep Relationships

Open Payments, a program created by the Physician Payments Sunshine Act (part of the Affordable Care Act) has started to come between drug representatives and physicians. For quite some time, physicians and pharmaceutical reps have had a warm relationship, with the latter coming to the offices of the former, bringing food, small gifts (i.e., pens), and educational material.

The relationships between reps and physicians started to come under scrutiny prior to the first release of Open Payments data, which keeps track of payments drug and device companies make to physicians and teaching hospitals for things like travel, research, gifts, speaking fees, and meals. The data also includes ownership interests held by physicians or their immediate family members in drug and device companies.

Since the release of Open Payments data, many studies have been done, purporting to show a negative link between the relationships pharma and physicians have. Myriad negative press followed those studies, making doctors and pharma out to be bad people for their interactions. We have written many times on the subject, including why we feel as though the relationships between doctors and pharma can actually be beneficial.

Now, however, it seems as though the bad press the relationships received is starting to have an effect. According to a new survey by SK&A, the percentage of physicians who do not allow access to medical industry salespeople has grown to 36.5% in 2016, up from just 22.9% in 2010.

Interestingly, for physicians employed by hospitals and health systems, the no-access rate tops 50%. This may be in part because physicians working for such employers tend to not make their own rules on seeing drug reps, the employers do.

The study also found that the ability of drug reps to get inside a physician’s office varies considerably by region. The no-access rate is highest in the West and lowest in the South. The state with the highest rate of physicians not granting access to drug reps is Vermont, with 63.7%, while the lowest state is Mississippi, with only 24.6% of its physicians denying access to drug reps.

The survey did find one trend that seems to run counter to the rest of the results, however: as the no-access rates increase, the requirement for appointments seems to be trending downward. The percentage of those who don’t require, or prefer, an appointment with a rep has fallen, from 49.8% in 2010 to 35.2% in 2016.

Such high rates of no-access may not be the best thing for the health care industry as a whole. While we do not think that physicians should look to pharma for lavish dinners out or speaking fees at events that don’t exist, we do believe that physicians should not feel like they are being blacklisted because a rep comes to visit their office and brings Papa Johns for the office. Such visits from drug and device reps can be beneficial to doctors and their staff, as it provides a time for them to ask questions of the rep to see if the offered device or prescription is a good fit for any of their patients.