Sunlight as disinfectant--new rules on disclosure of industry payments to physicians.

n engl j med 368;22 nejm.org may 30, 2013 2052 small-value gifts.5 The discrepancy between data sets also raises the possibility that some qualifying payments were not reported to the Massachusetts database. The federal Physician Payment Sunshine Act will soon require manufacturers to report most payments to physicians and teaching hospitals on a national level. Recently released rules indicate the intent to create a searchable system that will include the names of drugs or devices related to the payment. Descriptors for the type of relationship will be included as well, although the ones currently used in Massachusetts are of limited value, since the dominant category of “compensation for bona fide services” encompasses legitimate scientific as well as more controversial marketing relationships. However, many types of indirect payments, such as those made through intermediary organizations that host CME conferences, will be exempt from the national reporting requirement — which raises the possibility of some undetected payments. Nonetheless, the transparency offered by state or federal disclosure databases could be used in the future to explore relationships between financial interactions and health care outcomes or costs.