Big Bucks Behind the Scenes: Over $1 Billion in Doctor Payments Missing from New Health Database

The federal government’s Open Payments database, which discloses drug and device industry payments to doctors, has been reported to be missing more than $1 billion in payments made between August and December 2013. The database was created to promote transparency and reveal potential conflicts of interest but has faced significant criticism for its incompleteness and lack of user-friendly features.

Missing Data: A Major Concern

The Centers for Medicare and Medicaid Services (CMS) manages the Open Payments database. While the CMS acknowledged that some data would not be published, such as details on 9,000 disputed payments and data on 190,000 research payments related to drugs and devices not yet on the market, it did not initially disclose that the unpublished data represented almost a quarter of the total payments made during the latter part of 2013.

In addition to the missing data, the government withheld names of doctors and hospitals associated with 40 percent of published payments. They have promised to disclose this information next year, once it has been corrected and verified. These omissions, along with a difficult-to-use website, have fueled complaints about the Open Payments system.

Challenges for Patients and Doctors

One of the primary goals of the Open Payments database is to empower patients with information about their healthcare providers’ relationships with drug and device manufacturers. However, the substantial amount of missing and redacted data drastically limits the utility of the system for patients. Consumers may be deterred from using the site, given its incompleteness and complicated interface.

Doctors and pharmaceutical companies have also expressed frustration with the government’s timeline for correcting errors in the database. The Wall Street Journal has reported that the government does not plan to make necessary corrections until next year. Both patients and healthcare professionals would benefit from more prompt action to address these issues.

Transparency: More Than Just Dollars and Data

Although critics have pointed out the glaring flaws in the Open Payments database, it is important to note that this is just the beginning of what could become a more comprehensive and accurate resource for patients and providers alike. It will take time and effort to improve the transparency of information and eliminate potential conflicts of interest.

In the meantime, additional resources are available for patients who want to further explore drug pricing and potential physician-industry ties. For example, GoodRx is an online platform where consumers can compare drug prices at different pharmacies and find discount coupons.

Similarly, Doximity is a professional network for physicians that includes licensure, education, and board certifications in addition to information regarding potential conflicts of interest. Using multiple sources can help patients gain a more comprehensive understanding of their healthcare choices.

Next Steps

Despite its issues, the Open Payments database represents a significant step toward transparency in the relationship between healthcare providers and the drug and device industries. With continued improvements and increased data accuracy, it has the potential to become a valuable tool for patients to educate themselves and make informed healthcare decisions.

To maximize the potential of this resource, the federal government must address the database’s shortcomings promptly. Focusing on improving data completeness, accuracy, and user-friendliness will be crucial for creating a reliable and useful platform for patients and healthcare professionals alike.

Patients and healthcare providers can take advantage of additional resources like GoodRx and Doximity to supplement the information found in the Open Payments database. As patients become more knowledgeable about their healthcare choices and potential conflicts of interest, they will play an increasingly active role in shaping a more transparent and accountable healthcare system.