Over the weekend we blogged that the tipping point on disclosure of payments by pharma and device makers has already been reached. Between state and federal initiatives, and the rush to get ahead of regulation by voluntary disclosures, the industry will have to change. Those trying to hold back the tide (like the hotel industry) don’t see what’s happening.

More evidence today of the tide becoming a flood, from the WSJ:

A medical society representing U.S. spine surgeons has taken the rare step of requiring that researchers disclose not just the existence of financial ties to medical-device companies, but the dollar amounts as well.

The initiative is a response by the North American Spine Society to pressure from lawmakers, prosecutors and lawsuits by companies’ former employees. Prominent surgeons doing research have been found to have significant financial relationships — sometimes to the tune of millions of dollars — with medical-device firms.

NASS, which has more than 5,000 members, said the new disclosure policy will apply to doctors who present studies at future medical conferences.

The society said its policy “is not a voluntary guideline, but a binding covenant which applies to all relationships engaged in by all participants in all” activities of the spine society. Failure to disclose would be a “sanctionable offense,” the spine society said. Sanctions could include suspension, expulsion or public letters of censure. …

“It just became clear that more transparency is better,” said the spine society’s ethics-committee chairwoman, Marjorie Eskay-Auerbach, an orthopedic surgeon in Tucson, Ariz. She said she doesn’t know of other professional groups or journals with similarly stringent disclosure rules.
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In recent years, medical-implant makers Zimmer Holdings Inc., Stryker Corp., the DePuy orthopedics unit of Johnson & Johnson, and Biomet Inc. have paid more than $221 million to surgeon “consultants,” according to a Senate committee.

Medtronic Inc. has been accused by former employees and the government of inducing surgeons to use its spine products through questionable payments. In 2006, the Minneapolis company agreed to pay $40 million to the government to settle civil charges in federal court in Memphis, Tenn., that it paid kickbacks to doctors, but denied wrongdoing.

UPDATE: 20 minutes after we posted this, we saw this item from the Des Moines Register:

Iowa City, Ia. — A new University of Iowa policy would prohibit physicians from giving free drug samples to patients, a long-standing practice that hospital leaders and consumer advocates say contributes to the ballooning cost of health care.

Other changes include barring U of I Health Care employees from accepting gifts and meals from private companies and requiring all doctors who do industry consulting to report who they work for and how much they are paid.
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“Will I get a lot of tomatoes and rotten eggs? Yes,” [Vice President for Medical Affairs Jean] Robillard said. “But this is absolutely the right thing to do. We have a responsibility to our patients.”