“The fact that they’re disclosing information now could be chalked up to companies deciding to do the right thing. I take a more pragmatic view—they realize that disclosure requirements are coming. There’s the federal Sunshine law and, in some cases, certain states are taking measures, which could lead to a state-by-state effort, and it terrifies companies to have to deal with 50 different states.”

The recent Senate version of the health care reform legislation includes previously introduced legislation known as the Physicians Payment Sunshine Act, which has been spearheaded by U.S. Senator Chuck Grassley, who has investigated undisclosed conflicts of interest among academic researchers who receive both federal and industry funding.

The Sunshine provision would require drug and device makers to report payments or transfers to doctors in excess of $10 per transaction. And to prevent abuse of the $10 cap, the legislation limits the cumulative value of gifts to $100 annually. Several device makers, by the way, already disclose payments as part of a 2007 settlement with the federal government over kickback charges.

However, the measure has been languishing for a couple of years and, as a result, some states haven’t waited for Congress to take action. Since 1993, Minnesota has made available reports of payments by drugmakers to physicians, but the North Star State was joined recently by Vermont and Massachusetts, both of which significantly restrict payments and gifts to physicians.

The move last year by Massachusetts, in fact, set off a kind of brawl with the pharmaceutical industry, which warned the legislation would drastically curtail clinical trials in the state, which is home to a large number of hospitals and cutting-edge biotech facilities. Such an openly confrontational approach didn’t work very well. The bill passed.

And the ramifications are being felt in interesting ways. At a recent meeting in Boston of the American College of Emergency Physicians, one drugmaker, Schering-Plough, had a booth where free ice cream was being dished out—except to doctors who hail from Minnesota, Vermont, and Massachusetts. They had to go elsewhere. The message, according to industry watchdogs, is that drugmakers and doctors don’t share all the same goals.

“Look, speaker bureaus run by drugmakers just aren’t appropriate for medicine,” says Harvard’s Campbell. “The speakers don’t control the content. So if you’re a physician or an academic physician and you want to be a drug salesman, go do it. But not under the shroud of medicine or academia.”