After careful review and examination by several volunteer committees, the AVMA Board of Directors at its Jan. 8 meeting decided to take a position of “no action” on the Veterinarian Payments Sunshine Act, which has not yet been introduced in Congress. The Board believes that any new regulations imposed on the veterinary profession to disclose conflicts of interest should be rooted in a better understanding of if and where there are issues and has called for further examination of this topic by its expert leaders.
For those unfamiliar with the the act, it mimics the Physician Payments Sunshine Act, which was enacted as part of the Affordable Care Act in 2010 and requires manufacturers that develop drugs or medical devices for human medicine to disclose any payments or financial incentives they provide to physicians who use their products. In this case, “payments” includes any monetary amount or product provided that exceeds $10 in value. The Veterinarian Payments Sunshine Act has the same basic provisions, but also has some improvements that are the result of AVMA’s advocacy efforts. We’d prefer to play a proactive role in shaping potential legislation before it’s introduced to Congress; although it doesn’t always result in a product that’s ideal for us or the profession, it provides a valuable opportunity to prevent or mitigate damaging legislation.
When Rep. Louise Slaughter’s (D-N.Y.) office contacted our Governmental Relations Division (GRD) office regarding the act, GRD staff participated in numerous discussions and expressed concerns about several aspects of the draft legislation. We requested a higher dollar threshold for reporting, but that amount was considered non-negotiable by the congresswoman. We voiced concerns about items such as journal article reprints and texts that exceed $10 in value but are educational materials and not promotional materials. Our concerns were addressed in revisions to the draft, making it very clear that certain continuing education and scholarship sponsorship (through 3rd parties like AVMA and VMAs and allied orgs) are not considered gifts. It also excludes textbook/journal reprints, and educational materials. The provisions in the draft legislation do not create a direct burden for veterinarians, but we have concerns about potential unintended burdens. We will continue to advocate for the best possible outcome for the profession.
The Legislative Advisory Committee and Board of Directors considered a wide range of perspectives from within the profession regarding the draft legislation and what position the AVMA should take. Members of councils and committees expressed concerns about how the reporting system would be adapted to account for the differences in the delivery of human medicine and veterinary medicine; the impact of the legislation on the delivery of continuing education for veterinarians; additional administrative burdens and costs associated with compliance, and how those costs would affect the cost of veterinary care; and how the information would be used. Interactions between veterinarians and drug manufacturers are important when it comes to learning about products and providing important feedback, and we need to establish a balance that facilitates information exchange for the benefit of animal health and welfare without fostering a perception of undue influence.
Please know that a “no action” stance is essentially a neutral position on a piece of legislation. This means that the AVMA’s GRD will devote resources to explain that although AVMA supports transparency, we have concerns about the legislation that prevent us from supporting it.
We understand and are sensitive to the fact that some people perceive conflicts of interest can occur. We have been an advocate for full disclosure by our member veterinarians to ensure that they are open and honest with their clients when choosing pharmaceutical products to dispense or administer to their animal patients.
We were clear with the congresswoman’s office that while we share the commitment to increasing transparency between the veterinary profession and drug and device manufacturers, we may not agree with the “one size fits all” approach.
Our goal is to ensure that our member veterinarians can continue being regarded as the trustworthy doctors who care for and promote the good health and welfare of animals.