28 July 2017

Call to rethink disclosure rule changes

KnowCents Pharmacy

Pharmaceutical companies target health profession trainees at nearly 40% of the hundreds of education events they hold every week, according to new Australian research that adds to concerns about weaker sponsorship-transparency rules.

The research, collated from transparency reports by 42 pharmaceutical companies for the four years to September 2015, was conducted partly to gauge how much information will be lost under new Australian rules that do not seek disclosure of drug-makers’ hospitality.

“Pharmaceutical industry-funded events for health professionals were frequent and pervasive, with almost three and a half million attendances at over 116,000 events,” the authors, from Bond University and Sydney University, said in their research report.

With 610,000 health professionals registered in Australia in 2014, this showed wide exposure to pharmaceutical company marketing.

The 42 firms held 116,845 events  – 608 per week on average – hosting medical doctors on 82% of these occasions. More than 38% of events included trainees, and 21% attracted primary-care doctors.

Co-author Professor Lisa Bero, of Sydney’s Charles Perkins Centre and Faculty of Pharmacy, said the prevalence of trainees at these events was high but it was a well-known part of drug companies’ strategy to reach health professionals while they were still in training and impressionable.

“[The report] provides information to help us rethink (the transparency rules) for a couple of reasons,” she told The Medical Republic. 

“It really shows how ubiquitous this funding is, and how it is integrated into the everyday clinical situation. We know valuable information on payment, in terms of food and beverages, is being lost. We have data from other countries that shows prescribing is influenced by those small payments.”

The reporting companies invested a staggering $286,117,928 in sponsored events in 2011-15.  Almost all the events included hospitality; and at 65% of the events the only costs reported were for food and beverages.

Under Medicines Australia’s amended code of conduct, pharmaceutical companies are no longer asked to report on the hospitality component of events; only payments for individuals’ accommodation, travel expenses and speakers’ fees.

Brisbane GP Dr Justin Coleman said it was nonsensical to suggest hospitality at education events did not influence prescribing.

“It is not about whether the meal was $10 or $25.  It’s the fact that you are getting your education directly from the manufacturer of the product,” he said. “There have been plenty of studies showing that small gifts do induce some sense of reciprocal responsibility and as human beings we feel that, and that’s one of reasons it works.”

However, a tightening of the voluntary disclosure rules under Medicines Australia’s conduct code was highly unlikely without some kind of public outcry, he said.  The issue had “not been a high priority” for
the AMA.

The cross-sectional analysis research, reported in this month’s BMJ Open, was distilled from 301 voluntary reports by the 42 firms, representing about one-third of all PBS-listed drug suppliers.

The work had led to a world-first, open-access database that could be used internationally in research on medical education and pharma sponsorship, the authors said.

BMJ Open, online 18 July