Undisclosed pharmaceutical payments ‘a cause for concern’

Matt Woodley

7/02/2019 2:46:53 PM

A drop in disclosures related to pharmaceutical company payments to the Australian healthcare sector has prompted calls for more transparency.

Research has shown that pharmaceutical companies’ spending on events related their products can result in increased prescribing of unnecessary and costly drugs.
Research has shown that pharmaceutical companies’ spending on events related their products can result in increased prescribing of unnecessary and costly drugs.

University of Sydney research, published in BMJ Open, revealed a 34.1% reduction in disclosed spending by member companies of Medicines Australia in 2016, the year after changes were made to the pharmaceutical industry’s codes of conduct.
According to study co-author Dr Lisa Parker, the changes have allowed companies to hide the amount spent on food and beverages at events and for sponsored healthcare professionals, something she describes as ‘a cause for concern’.
‘Even the provision of modest meals at such educational events hosted by pharmaceutical companies can influence prescribing behaviour of healthcare professionals,’ Dr Parker said.
‘The new code also fails to require disclosures about other industry interactions with health professionals that countries such as the UK and USA have introduced, such as pharmaceutical company spending on free drug samples and funding for research.’
Previous research has shown that pharmaceutical companies’ spending on events related their products, as well as payments to individual health professionals, health consumer groups and third parties such as hospitals, can result in increased prescribing of unnecessary and costly drugs.
Immediate past Chair of the RACGP Expert Committee – Quality Care (REC–QC) and long-time advocate of increased transparency in the pharmaceutical industry, Dr Evan Ackerman, welcomed the report’s findings and said they ‘clearly demonstrate’ that self-regulation is not working.
‘This research shines a light on the real world impact of political decisions,’ Dr Ackerman told newsGP.
‘I would suggest more comprehensive reporting, including drug company donations to political parties, and donations to “consumer advocacy groups” should also be made public so a complete picture can be garnered.’
However, a spokesperson for The Pharmacy Guild of Australia told newsGP the current regime implemented by Medicines Australia is already ‘robust’.
‘The self-regulation of educational activities in the pharmaceutical industry should be rigorous and transparent,’ the spokesperson said.
‘[But], care needs to be taken to ensure that any such regime, however regulated, does not impede the availability of legitimate educational and training activity for health professionals around prescription medicines.’

Dr Evan Ackermann believes the study’s findings ‘clearly demonstrate’ that self-regulation is not working.

Medicines Australia CEO Ms Elizabeth de Somer also defended the current regulatory arrangement and cast doubt on the report’s findings.
‘The code of conduct is the Australian benchmark for accountability and transparency reporting in the Australian therapeutic goods sector,’ Ms de Somer said.
‘It is ludicrous to suggest that a modest lunch would sway the opinions of medical practitioners – whether it’s captured under our code or not.
‘Suggestions, like the one published in the BMJ, do nothing but undermine patients’ confidence in a robust and accountable system, seek to break the trust that is fundamental to all those involved in delivering medicines to patients, and insults the judgement of healthcare professionals.’

According to the study, one positive outcome from the 2015 changes is that companies must now report the names of individual health professionals who receive payments. However, according to Dr Parker, the changes have also added an extra layer of complexity.
‘Payments are scattered in more databases and the data in each of them is difficult to understand,’ Dr Parker said.
‘This is hindering transparency when there is increasing societal interest in disclosure.’
Aside from highlighting reduced transparency following changes to the code, the study’s authors also propose mandatory disclosure on spending by pharmaceutical companies.
‘This study demonstrates the limitations of a self-regulatory system, which can be quietly changed in such a way as to reduce overall public reporting of industry funding in the healthcare sector,’ study co-author Professor Lisa Bero said.
‘We recommend expanding the reporting to include funding of drug samples and research, and that legislation reinstates previously compulsory reporting of food, beverages and venue costs at company-run educational events and advisory board meetings.
‘Of course, while transparency is essential, limiting or preventing such spend – and the resulting potential impacts – would be ideal.’
Dr Ackerman agrees that mandatory reporting would be an improvement and said the reduced transparency resulting from current self-regulatory practices is a ‘disservice to the Australian community’.
‘I would support the authors’ recommendation of new legislation to improve the transparency around spending on pharmacy, healthcare professionals and health consumer groups, and to mandatorily include all companies in the pharmaceutical and medical device sector,’ he said.
Pharmaceutical companies reported spending $9,486,078 on third-party meeting sponsorship activities between 1 November 2017 and 30 April 2018, including $853,129 on ‘hospitality specific sponsorship’.
Payments to health consumer organisations totalled $7,679,389 in 2017, according to the most recent report summary made available by Medicines Australia.

Update: This article has been updated to include Elizabeth de Somer’s comments.

Medicines Australia pharmaceutical companies Pharmacy Guild of Australia University of Sydney

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