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Early Experiences With Disclosure Laws in Vermont and Minnesota

Joseph S. Ross, MD, MHS; Josh E. Lackner, BS; Peter Lurie, MD, MPH; Cary P. Gross, MD; Sidney Wolfe, MD; Harlan M. Krumholz, MD, SM

JAMA. 2007;297:1216-1223.

Context  Recent legislation in 5 states and the District of Columbia mandated state disclosure of payments made to physicians by pharmaceutical companies. In 2 of these states, Vermont and Minnesota, payment disclosures are publicly available.

Objectives  To determine the accessibility and quality of the data available in Vermont and Minnesota and to describe the prevalence and magnitude of disclosed payments.

Design and Setting  Cross-sectional analysis of publicly available data from July 1, 2002, through June 30, 2004, in Vermont and from January 1, 2002, through December 31, 2004, in Minnesota.

Main Outcome Measures  Accessibility and quality of disclosure data and the number, value, and type of payments of $100 or more to physicians.

Results  Access to payment data required extensive negotiation with the Office of the Vermont Attorney General and manual photocopying of individual disclosure forms at Minnesota's State Board of Pharmacy. In Vermont, 61% of payments were not released to the public because pharmaceutical companies designated them as trade secrets and 75% of publicly disclosed payments were missing information necessary to identify the recipient. In Minnesota, 25% of companies reported in each of the 3 years. In Vermont, among 12 227 payments totaling $2.18 million publicly disclosed, there were 2416 payments of $100 or more to physicians; total, $1.01 million; median payment, $177 (range, $100-$20 000). In Minnesota, among 6946 payments totaling $30.96 million publicly disclosed, there were 6238 payments of $100 or more to physicians; total, $22.39 million; median payment, $1000 (range, $100-$922 239). Physician-specific analyses were possible only in Minnesota, identifying 2388 distinct physicians who received payment of $100 or more; median number of payments received, 1 (range, 1-88) and the median amount received, $1000 (range, $100-$1 178 203).

Conclusions  The Vermont and Minnesota laws requiring disclosure of payments do not provide easy access to payment information for the public and are of limited quality once accessed. However, substantial numbers of payments of $100 or more were made to physicians by pharmaceutical companies.

Author Affiliations: Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, and the Geriatrics Research, Education, and Clinical Center, James J. Peters VA Medical Center, Bronx, NY (Dr Ross); Health Research Group, Public Citizen, Washington, DC (Mr Lackner, Drs Lurie and Wolfe); Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn (Drs Gross and Krumholz); Section of General Internal Medicine, Department of Medicine, Yale University School of Medicine (Dr Gross); Section of Health Policy and Administration, Department of Epidemiology and Public Health, and Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine and the Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Conn (Dr Krumholz).

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