Biopharmas to disclose payments to nurses under bipartisan opioid bill

Drug and medical device manufacturers have been reporting financial relationships with physicians to the U.S. government for years under the Physician Payments Sunshine Act. The target will expand to nurses and other medical professionals under a new bill that is expected to soon be enacted.

The new provision was buried deep in a 660-page bill (PDF) aimed primarily at tackling the opioid crisis. It requires that payment disclosure would also apply to clinical nurses, physician assistants, anesthetists and nurse-midwives.

The House and Senate have previously each passed their own versions with overwhelming votes in favor, and lawmakers from both chambers have just came out with an agreement on a finalized legislation package. The bill will likely be voted through the Congress and reach President Donald Trump’s desk soon, given the rare bipartisan support for it.

"There is bipartisan urgency for both of our chambers to pass this consensus legislation so the President can sign it as soon as possible," said Senate Health Committee Chairman Lamar Alexander, R-Tenn., in a statement.

In different states, nurse practitioners have various levels of authority to prescribe drugs, including opioids, with or without physician oversight.

While the previous Sunshine law already mandated that drugmakers disclose physician payment information to the Centers for Medicare and Medicaid Services, allegations emerged during the growing opioid crises that some drugmakers offered kickbacks to doctors and nurses to boost prescriptions.

Insys Therapeutics, producer of under-the-tongue fentanyl spray Subsys, recently reached a $150 million agreement with the Department of Justice to settle accusations over its opioid off-label marketing. Others, like Johnson & Johnson, Mylan, Depomed and Purdue Pharma, have been involved in similar probes by public prosecutors or lawmakers.

Worrying that pharma companies could be using gifts and payments to influence the prescribing practices of not just doctors, but other healthcare practitioners like nurses and physicians assistants, Sens. Chuck Grassley, R-Iowa, Richard Blumenthal, D-Conn., and Sherrod Brown, D-Ohio, introduced the proposed addition to the Sunshine law in May.

"By shining a light on the relationship between drug companies and prescriptions for opioids, greater accountability will be achieved," the senators said in a release at the time.

Echoing the lawmakers concern, California’s insurance commissioner Dave Jones recently filed a suit against AbbVie, alleging that the company used nurse "ambassadors" as a way to induce doctors to prescribe Humira. AbbVie defended itself, saying it believes "the allegations are without merit," and that the nurses do not "replace or interfere with interactions between patients and their healthcare providers."

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