8 March 2017

Pharma reporting still leaves gaps in money trail

Ethics Pharmaceuticals

 

The latest figures on drug company spending on healthcare professionals have been released, with six out of 35 companies putting more than the $1 million each into funding event registrations, travel and accommodation costs, fees for service and consultancies.

Pfizer topped the list at nearly $1.9 million in total spending, followed by Boehringer Ingelheim at $1.38 million, while Bayer spent just over $1.2 million. The other companies with payments of more than $1 million were AstraZeneca, Novartis and BMS.

Analysis showed an average spending of $600,000 per company between 1 May and 31 October 2016, with the lowest spending by Vifor, at $20,410.

The figures were released as part of transparency reporting requirements of the Medicines Australia code of conduct. The code requires consenting healthcare professionals to be named as recipients of funding, but around 40% of doctors chose to remain anonymous.

Pfizer’s faceless beneficiaries made up 52% of all payees, while 54% of healthcare professionals did not provide consent to Boehringer Ingelheim for their names to be reported.

The option to remain anonymous is being phased out however, and from this year all healthcare professionals receiving payments will named in reports.

“The ACCC insisted [that Medicines Australia] get rid of that opt out clause – that’s very positive,” Dr Barbara Mintzes, a research scientist specialising in pharmaceutical policy at the University of Sydney, said.

Dr Justin Coleman, a Queensland GP who was part of the Transparency Working Group, said naming individuals would make healthcare professionals more likely to disclose conflicts
of interest.

This was important, he said, because pharmaceutical companies often targeted payments at healthcare professionals who exerted influence around GP prescriptions and the flow of taxpayer dollars.

“In the past, it was possible to wield all that influence with no-one having the capacity to discover whether you are receiving money or not from the drug companies involved unless you … declared it,” said Dr Coleman.

But under the revamped system introduced late last year, reporting no longer included hospitality costs related to wining and dining. These costs made up a hefty proportion of the total spend by drug companies, Dr Mintzes said.

Currently, the reporting of spending does not exist in a single database, which makes data extraction difficult.

This change was concerning to Dr Mintzes because research showed even small gifts could influence prescribing behaviour. A US study published in JAMA Internal Medicine last year showed that receiving one sponsored meal valued at just $20 made doctors more likely to prescribe a branded drug over the generic version.

Dr Mintzes said another missing piece of information in the reports was the specific drug being promoted to healthcare professionals. While the 2010 Sunshine Act in the US made drug companies tie funding disclosures to specific drug promotions, this information was not required of Australian pharmaceutical companies.

This made analysis of drug company influence on prescribing habits more difficult, Dr Mintzes said.

Currently, the reporting of spending did not exist in a single database, which made data extraction difficult, according to Dr Coleman.

“If you are particularly curious about a doctor, you have to run through 35 different websites to find [which companies they are receiving payments from],” he said.

A spokeswoman for Medicines Australia said the group had made efforts to explore employing a centralised database.

Dr Coleman said Medicines Australia had originally pushed for data to be made available in read-only PDFs, but were eventually instructed by the ACCC to provide information in Excel or CSV format.

“[That] at least makes it possible for someone to collate it,” said Dr Coleman. “It is still very difficult. There was active resistance to making it easy from the member companies, for whatever reason.”

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