drug moneyA new federal database meant to increase financial transparency between the drug and device industry isn’t quite so transparent yet. The system is missing $1.1 billion worth of payments.

At least 9,000 payments had been formally disputed by doctors or hospitals before the launch this fall. So, they were not published, but they have since been researched and are set to publish in December.

The Centers for Medicaid and Medicare Services also delayed publication of another 190,000 research payments related to drugs and devices that are not yet on the market, as allowed by law. Together, those 199,000 records represent about $1.1 billion. That’s a quarter of the payments dispensed in the last five months of 2013.

CMS extended the date by which doctors and hospitals could dispute information in the data, giving them until the end of October to to submit corrections for publication on or before Dec. 31.

The CMS launched Open Payments, also known as the Physician Payments Sunshine Act, on Sept. 30. It registered 4.4 million payments from the manufacturers of drugs, medical equipment or supplies to physicians and teaching hospitals valued at $3.5 billion between August and December 2013. About 546,000 doctors and 1,360 teaching hospitals received at least one payment. The database has a search tool by physician name, teaching hospital and company.

Many medical professionals are wary, saying the website doesn’t provide needed context. It is difficult from the data to see if the relationship is legitimate or not, and there’s also the worry about errors.

“I think many physicians are concerned about the accuracy of the database,” said American Heart Association President Dr. Elliott Antman.

Under the new requirements, part of the Affordable Care Act, all manufacturers of drugs, medical devices and medical supplies that have at least one product covered by Medicare or Medicaid must report payments or gifts they make to doctors and teaching hospitals. All payments above $10 – meals, travel expenses and speakers’ fees – are included.

“Given the complexities of research, for example, and the many routes by which funds flow through institutions, there is a clear need to distinguish support for clinical trials funneled through a research and grants contract mechanism at a hospital, versus individual physician payments,” said Antman, professor of medicine and associate dean at Harvard Medical School. He also is a senior physician in the Cardiovascular Division of the Brigham and Women’s Hospital in Boston.

Many of the fields aren’t complete and some don’t disclose the nature of the payment. “Trying to examine some test cases in the database is likely to illustrate some of the limitations of the information,” he said.

The first reporting period covers transactions from the last five months of 2013.  Future reports will be published every year and will include a full 12 months of payment data. Information for 2014 will be made public on June 30, 2015.

ProPublica, a nonprofit investigative news group, began compiling its own list of payments that drug companies make to physicians in 2010. Its publicly searchable database allows patients to look up their doctors. In 2013, it tracked 17 companies that spent $1.4 billion.

Display at a stand offering coffee to doctors at Scientific Sessions 2014

Display at a display stand offering coffee to doctors at Scientific Sessions 2014