Abstract | „Svjetlost za liječnike“ (engl. Sunshine Act) je zakon koji obvezuje proizvođače lijekova, medicinskih
proizvoda i bioloških lijekova, te udruge nabavnih djelatnosti koje sudjeluju u američkim programima
zdravstvene zaštite, na prijavu određenih plaćanja i vrijednosnih predmeta danih liječnicima te nastavnim
bolnicama. U Program transparentnog plaćanja uključeni su liječnici i farmaceuti. Cilj ovog istraživanja bio je
utvrditi broj uključenih farmaceuta i njihovu klasifikaciju u Programu transparentnog plaćanja, broj i iznose
transfera vrijednosti, najsponzoriranije lijekove, te razlike između onih sponzoriranih obje godine (2013. i
2014.godina) i onih sponzoriranih samo jedne godine.
Sa stranice američkog centra za zdravstveno osiguranje; preuzeli smo dvije baze podataka o uplatama
farmaceutskih tvrtki prema liječnicima za 2013. i 2014. godinu. Podatci u bazi obuhvaćaju vremenski period od
1. kolovoza do 31. prosinca za 2013. godinu i period od 1. siječnja do 31. prosinca za 2014. godinu. Suzili smo
pretragu i analizu na sve subspecijalizacije farmaceuta.
U bazi smo pronašli 665 prijavljenih farmaceuta kojima je u obje godine ukupno izvršeno 1 910 transfera
vrijednosti. Prosječan iznos transfera vrijednosti po farmaceutu nije bio velik, iznosio je 21,1 dolar (samo 2013.
godina), 29,5 dolara (samo 2014.), 61,7 dolara (2013. i 2014.). Od njih najviše ih je klasificirano kao „pružatelji
farmaceutskih usluga“, farmaceut specijaliziran za onkološke pacijente“, i to 66,1%. Farmaceuti koji su primili
uplate u obje godine, nisu u 2013. primili statistički više uplata od onih koji nisu ponovno sponzorirani 2014.
godine, ali su primili statistički više u 2014. godini (21,1 95% CI 18-25 vs 35,5 95% CI 28-44, Mann-Whitney U
test P<0,0001). Najsponzoriraniji lijekovi bili su: Victoza, Silenor, Xtandi, Botox, SGN35. Kategorija s
najvećim brojem uplata, bila je kategorija hrane i pića, a kategorija s najvećim udjelom u ukupnom iznosu uplata
kategorija naknada za savjetovanje s 85,2%.
Iako farmaceuti čine samo 0,11% onih za koje je objavljen transfer vrijednosti., postoji razlika u farmaceutima
koji su primili transfer u 2013. i 2014. naspram onih koji su primili transfer u samo jednoj godini. Bez podataka
o propisivanju ili preporučivanju lijekova, nije moguće utvrditi povećava li doista objava podataka u javnoj bazi
povjerenje pacijenata prema farmaceutima. |
Abstract (english) | The Physician Payments Sunshine Act (Sunshine Act) requires manufacturers of drugs, medical
devices and biologicals that participate in U.S. federal health care programs to report certain payments and items
of value given to physicians and teaching hospitals. Open payments program includes physicians and
pharmacists. The aim of this study was to determine the number of pharmacists involved and their classification
in the Program, number and amount of transfer of values, most sponsored drugs, the difference between those
sponsored both years (2013 and 2014) and those sponsored only one year.
We took two databases about transfers of values made to physicians by pharmaceutical companies in 2013 and
2014 from the web site of Centers for Medicare & Medicaid Services (CMS). The collected data refers to time
period from August 1 2013 to December 31 2013 and period from January 1 2014 to December 31 2014.
There were 665 pharmacist registered in the database with 1910 transfers of values made. The average amount of
the transfer value per pharmacist was 21.1 dollar (in 2013), 29.5 dollars (in 2014), 61.7 dollars (in 2013 and
2014). Most (66.1%) of the registered were classified as Providers of pharmaceutical services, pharmacist,
oncology. Pharmacists who received payments in both years haven't received statistically more than those who
were not sponsored again in 2014, but received statistically more in 2014 (21.1, 95% CI 18-25 vs. 35.5 95 % CI
28-44, Mann-Whitney U-test P <0.0001). Most sponsored drugs were: Victoza, Silenor, Xtand, Botox, SGN35.
A category with the highest number of payments was the category of food and drinks, while the category with
the largest share in the total sum of payments was consulting fees with 85.2%.
Pharmacists constitute only 0.11% of those registered in the Open payments program. Pharmacists sponsored
each year have received greater amounts of transfer value. Although pharmacists make up only 0.11% of those
who received transfers of values, there is a difference in the pharmacists who have received transfers in both
years compared to those who received a transfer in only one year. Since the database does not hold data about
drug prescribed or recommended by practitioners, it is not possible to know if this transparency of data increases
patients’ confidence towards pharmacist. |