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Washington -- A key senator has sent letters to more than 30 health care organizations requesting information about the financial backing they receive from the pharmaceutical, medical device and insurance industries.

The American Medical Association, the American Academy of Family Physicians, the American Hospital Assn., the American Society of Anesthesiologists, the American College of Surgeons and the American Cancer Society were among the groups that received a Dec. 7 letter from Sen. Charles Grassley (R, Iowa), the ranking GOP member on the Senate Finance Committee. Grassley has a reputation for being an industry watchdog, including when it comes to consulting arrangements and funding for continuing medical education from pharmaceutical firms.

Grassley requested that the groups send him, by Dec. 21, accounting information dating back to January 2006, detailing grants, donations and meeting sponsorships from industry sources.

"These organizations have a lot of influence over public policy, and people rely on their leadership," he said. Some of the groups have supported Democratic efforts this year to overhaul the health system -- proposals Grassley opposes.

Grassley also has asked for details of the disclosure requirements for the organizations' top executives and board members, as well as any policies the organizations plan to adopt to ensure transparency of funding. The senator said the information is necessary to ensure greater public trust and proof of independence within the organizations.

"The American Medical Association received Sen. Grassley's letter and is in the process of collecting information to fulfill the request," the AMA said in a statement.

Steve Weiss, a spokesman for the American Cancer Society, said it also would work to provide the requested information. He added that his organization "holds itself to the highest standards of transparency and public accountability."

Even though the AAFP intends to fulfill the senator's requirements, Doug Henley, MD, said he wished the organizations were given more time to honor the request, given the holiday season and the continuing health system reform debate.

"That said, we will respond by the date requested," said Dr. Henley, AAFP's executive vice president and CEO. "We have a significant amount of information that we hope will be helpful to the senator."

About 32% of AAFP's budget comes from pharmaceutical funding, most of which goes toward journal advertising, exhibits at conferences and grants for continuing medical education, Dr. Henley said. "We have not hidden the funding we have received from the pharmaceutical industry, nor should we. We are following various guidelines to show we are transparent and serious about separating the funder from conflict-of-interest issues and bias as it pertains to content."

The NAMI precedent

This inquiry follows the same line as a recent review of industry support for the National Alliance on Mental Illness.

After determining that the national coalition received almost two-thirds of its funding from the drug industry, Grassley sent letters Oct. 6 to all 50 NAMI state chapters asking them to disclose income from pharmaceutical companies. A few days later, according to Grassley, a founding member of the alliance resigned, citing displeasure with its reliance on drug dollars.

Last spring, NAMI started posting on its Web site any funding exceeding $5,000 that it received from drug companies and other foundations.

Michael Fitzpatrick, NAMI's executive director, said the organization has made public the identity of its backers for years, but it decided to start posting specific amounts due to a desire to be more transparent and a weariness of responding to inquiries about the process.

"We've been talking about this for a year or so internally about what to post and what not to post," Fitzpatrick said. "We've always disclosed who funds us, but we really didn't want to share a specific amount, because we all compete against each other for the same money. But transparency is important to us, and it's actually worked out well. We've received some good feedback. I think it's important for organizations to be clear on funding, particularly when it comes from the substantial funders."

Grassley said the associations spotlighted in the new round of inquiries should follow NAMI's lead.

The senator also is working to pass legislation that would require certain financial relationships between physicians, drug companies, insurers and device makers to be revealed publicly. The Physician Payments Sunshine Act, co-sponsored by Sen. Herb Kohl (D, Wis.), would require that any payment to doctors from industry that exceeds $100 over the course of a year be posted on a government-operated Web site.

"I'm interested in transparency," Grassley said. "Letting the sun shine in and making information public is basic to building people's confidence in medical research, education and the practice of medicine."

AMA policy states that physicians should refuse gifts that do not benefit patients or are worth more than $100, disclose financial conflicts, and refuse company stock when doing clinical research. AMA policy also says doctors must never put financial interests before the welfare of patients.

This content was published online only.

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