1. Case Studies in the Implementation of a Physician Payment Disclosure Initiative Michael P. Bigelow Assistant General Counsel Eli Lilly and Company

2. Copyright © 2009 Eli Lilly and Company Where to Begin? What are you going to disclose? –Payments, expenses, gifts, other info? Why are you disclosing? –Voluntary, CIA/DPA Required, State law, Federal law? To whom does this apply? –Doctors, All HCPs, Clinical work, Speaking, Consulting? Do you have the right to disclose? Is everyone on-board (internally)? Do the speakers/consultants understand why?

3. Copyright © 2009 Eli Lilly and Company Do not expect that your Speakers/Consultants will understand “why”? Main issue surrounds the potential for conflicts of interest States and federal government are legislating on this issue Congress is investigating doctors and companies Huge media issue Yet, despite all the attention, many HCPs do not see this as a big issue for them (or us) –Do not fully appreciate why we are disclosing this information

4. Copyright © 2009 Eli Lilly and Company What to do about it? Take the time to educate your speakers and consultants on this issue How? –Teleconferences with speakers and consultants –Q & A’s, backgrounders –Letters to speakers and consultants on the topic and your rationale for disclosing –Letters to editor on the topic –Need to tell our story to the public –Discuss during live speaker training –1-1 calls with speakers

5. Copyright © 2009 Eli Lilly and Company Concerns of Speakers/Consultants Have to explain to patients that no conflict of interest exists –Takes time to do Not sure how “real” the public concerns are Will the numbers be the same as what they report to their employers –e.g., Are expenses included? Patients won’t understand the value of the services they provide –Reputations are at risk –Certain specialties tend to get singled out

6. Copyright © 2009 Eli Lilly and Company Lessons Learned –Take the time to brief your speakers/consultants on why you are disclosing –Benefits to them and to industry – Make sure that your speakers/consultants have the tools they need to discuss the issue with their patients –Help the doctors explain the issue –Op-eds on the subject –Briefings with media and legislators –Ensure appropriate internal alignment on the issue – Be prepared: You will lose some faculty if you choose to disclose payment information