An H1 'Insight': The Importance of Using Open Payment Data

Ariel Katz
Sep 17, 2020

If you hear the term “Sunshine Act” and think of summer, beaches, and drinks with little paper umbrellas you would be far off the mark - but forgiven, for who can be blamed for dreaming a little. The 2010 “Physician Payments Sunshine Act” doesn’t deal with sunshine but with data, specifically, data about the financial relationships between the healthcare industry, physicians, and teaching hospitals.

Under the Affordable Care Act (ACA) the Centers for Medicare & Medicaid Services (CMS) were given the legal mandate to collect information about the payments drug and medical device manufacturers make to physicians and teaching hospitals. CMS addressed this mandate by creating the Open Payments Program and making the data it gathers publicly available and searchable through the Open Payments website.

Sunshine Brings Transparency

The goal of the Sunshine Act, also known as section 6002 of the ACA of 2010, is to increase transparency and bring potential conflict of interest to light. Everybody can now find out whether and, if so, how much money a specific doctor or hospital receives from pharma or medical device companies and for what. Before companies could make undisclosed payments to doctors for things like consulting or speaking at a conference, they could fund research or pay from meals and other expenses without oversight. This practice raised concerns about undue influence companies could exert on medical professionals.

Data Captured by the Sunshine Act

Companies make payments to physicians and hospitals for a number of reasons. The Open Payments database aims to capture all “payments and transfers of value” above $10 as well as  yearly combined payments if the payments from one manufacturer exceed $100 per physician or teaching hospital. Here is a short overview of the types of payments captured within Open Payments. A more detailed version of the table including examples can be found here.


What Can Open Payment Data Do for You?

Most patients won’t be digging around a database with 11 million entries to find out whether their podiatrist got treated to a free lunch by the sales rep of a medical device company. Though this information is available using the Open Payments Data Explorer.

However, for Healthcare or Life Science companies, the Open Payments database is a treasure trove of information that they ignore at their own peril. General information that can be observed includes: the types of payments made, which organizations give and receive the most money overall or for a specific product category, what specialties obtain the most– or least – funding, which geographic areas benefit the most. Since data from prior years are accessible as well, trends in payments can be observed. In addition,  insights can be gleaned to support market landscaping and identification of KOLs.

Here is a summary of potential applications of Open Payment data:

·    Paint a clear picture of what your competition is doing: Open Payment data will tell you whom are they paying, how much, and for what. This information helps to offer competitive rates to experts while not overpaying.

·    Identify the most highly paid - and with that, sought-after physicians - for a disease area. The data will allow you to tease out the top-ranking professionals for different tasks, e.g. the physician with the most research dollars might not be the one who gets the most speaking engagements. This information can guide the decision of which physician or teaching hospital to approach as a KOL or PI.

·    Provide insights into your KOLs’ other activities. Whom are they working for and in what capacity? How much does the competition pay them?

·    Flesh out your competitive landscaping by taking a deep dive into the data in your target areas. Who is investing in the same areas? Who is hiring the same experts?

·    Find the rising stars. Today’s top expert might be the one you want to hire but a relative newcomer on the rise might be a great alternative. Open Payment data make it possible to identify experts on all levels.

·    Search for outliers. If a company that hasn’t been on your radar as a competitor invests in R&D or hires a KOL in your area, this is a definite signal to keep close tabs on them.

Open Payment data are a source of important market and competitive information. While it is free to access, analyzing the data requires a serious and concerted effort across several functions within an organization. H1's unique ability to map open payments to the physicians in our database makes open payment data easy to locate and analyze. Open Payment data contain relevant information for sales, R&D, medical affairs, compliance and marketing and a cross-functional approach to reviewing, analyzing and developing actionable goals based on the Open Payment data is required to get the most out of this resource.

Head to the H1 website for more information on Open Payment data.