[Congressional Record Volume 153, Number 131 (Thursday, September 6, 2007)]
[Senate]
[Pages S11217-S11218]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRASSLEY (for himself, Mr. Kohl, Mr. Kennedy, Mrs. 
        McCaskill, Mr. Schumer, and Ms. Klobuchar):
  S. 2029. A bill to amend title XI of the Social Security Act to 
provide for transparency in the relationship between physicians and 
manufacturers of

[[Page S11218]]

drugs, devices, or medical supplies for which payment is made under 
Medicare, Medicaid, or SCHIP; to the Committee on Finance.
  Mr. GRASSLEY. Mr. President, a month ago I outlined an important 
issue affecting all Americans who take prescription drugs or use 
medical devices--the need for greater transparency in the money that 
drug and device companies hand out to doctors. Today, I am pleased to 
introduce the Physician Payments Sunshine Act, along with Senator Kohl, 
chairman of the Special Committee on Aging. This legislation will bring 
much needed transparency to the financial relationships that exist 
between the drug and device industries and doctors.
  There is no question that the drug and device industries have an 
intricate network of financial ties with practicing physicians. These 
financial relationships can take many forms. They can include speaking 
honoraria, consulting fees, free travel to exotic locations for 
conferences, or funding for research. Drug and device companies spend 
billions and billions of dollars every year marketing their products. A 
good amount of this money goes directly to doctors in the form of these 
payments.
  This practice, and the lack of transparency around it, can obscure 
the most important question that exists between doctor and patient: 
What is best for the patient?
  As the editorial board of the Des Moines Register wrote recently, and 
I quote, ``Your doctor's hands may be in the till of a drug company. So 
how can you know whether the prescription he or she writes is in your 
best interest, or the best interest of a drug company?'' That is an 
excellent question. Currently, the public has no way of knowing whether 
their doctor has taken payments from the drug and device industries, 
and I intend to change that--not just for Iowans but for all Americans.
  Payments to a doctor can be big or small. They can be a simple dinner 
after work or they can add up to tens of thousands and even hundreds of 
thousands of dollars each year. That is right--hundreds of thousands of 
dollars for one doctor. It is really pretty shocking.
  Companies wouldn't be paying this money unless it had a direct effect 
on the prescriptions doctors write, and the medical devices they use. 
Patients, of course, are in the dark about whether their doctor is 
receiving this money.
  The Physician Payments Sunshine Act sheds light on these hidden 
payments and obscured interests through the best disinfectant of all: 
sunshine. This is a short bill, and a simple one. This bill requires 
drug and device manufacturers to disclose to the Secretary of Health 
and Human Services, on a quarterly basis, anything of value given to 
doctors, such as payments, gifts, honoraria, or travel. Along with the 
money, these companies will have to report the name of the physician, 
the value and the date of the payment or gift, its purpose, and what, 
if anything, was received in exchange. This bill then requires the 
Department of Health and Human Services to make the information 
available to the public through a searchable web site.
  And this bill has some teeth, too. If a company fails to report, the 
Physician Payments Sunshine Act imposes a penalty ranging from $10,000 
to $100,000 for each violation.
  Many States are ahead of the curve on this and have passed, or are 
currently considering, similar measures. In 1993, Minnesota required 
the Nation's first public disclosure of gifts and payments from 
wholesale drug distributors. Vermont passed a similar law in 2003, 
although much of the information is not publicly available. More 
recently, the District of Columbia, Maine, and West Virginia have 
followed suit in requiring disclosure, though not all make the 
information available to the public through a web site. The General 
Assembly in my home State of Iowa may soon be requiring disclosure as 
well.
  But this kind of information shouldn't be available only to Americans 
who happen to be lucky enough to live in a State already addressing 
this problem. On the contrary, this information should be accessible to 
all Americans across the country and it should be updated in a timely 
manner. I propose to my colleagues that now is the time to act.
  I realize that some critics, including many of the drug and device 
companies, are going to say that creating this sort of national 
database is too time consuming and too expensive. I can hear the 
complaints already. But let me remind you again--the drug companies are 
already reporting their payments to doctors in Minnesota and other 
States. Companies already have this information available. We aren't 
requiring them to go out and obtain it--we are just asking them to 
share it with the American people.
  Perhaps even more telling is that at least one industry leader has 
taken the goal of increased transparency into its own hands. Although 
it is not making its payments to doctors publicly available, Eli Lilly 
has taken important steps to meet the public's demand for increased 
sunshine. In response to my investigation of drug company payments for 
continuing medical education, Eli v Lilly voluntarily created a web 
site that details payments they make to organizations like patient 
groups and hospitals. I commend Eli Lilly for taking the lead on that 
issue, and I look forward to working with them on my latest effort.
  This bill is careful not to burden small businesses--it applies only 
to companies with annual revenues over $100 million. It is the largest 
companies who are driving this practice, and for whom disclosure would 
be least burdensome.
  Further, during a meeting on a separate matter with officials from 
Glaxo Smith Kline in early August, my staff brought up the idea of drug 
companies reporting payments to physicians. I am happy to say that Dr. 
Moncef Slaoui, the chairman of research and evelopment for Glaxo Smith 
Kline, said that he was also interested in a little sunshine. In fact, 
here are his exact words: ``We're happy for transparency.'' I would 
like to commend Dr. Slaoui for his comments and I look forward to 
working with him and leaders at other companies on this bill.
  It is not only industry leaders who are leading the way on the issue 
of increased transparency--some of America's best medical schools are 
taking steps to prevent conflicts of interest among their physicians. 
In fact, the Yale University School of Medicine, the University of 
Pennsylvania, and the Stanford University Medical School have gone so 
far as to prohibit certain gifts and payments altogether.
  So let me be clear. This bill does not regulate the business of the 
drug and device industries. I say, let the people in the industry do 
their business. After all, they have the training and the skill to get 
that job done. Just keep the American people apprised of the business 
you are doing and how you are doing it. Let a little bit of sunshine in 
to this world of financial relationships--it is, after all, the best 
disinfectant.

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