Payments made from pharma to the healthcare sector have been under increased scrutiny of late. However, transparency reporting from the industry is in decline leading to calls for mandatory disclose of payments.
Research shows that when pharma companies make payments to individual health professionals, health consumer groups and third parties such as hospitals there can be serious consequences – such as increased prescribing of unnecessary and costly drugs.
Although Australia was once at the forefront of transparency around this type of spending, a new paper published this week in BMJ Open reveals the nation is now falling behind.
Following updates of Australian pharmaceutical industry Codes of Conduct in 2015, researchers from the Evidence, Policy and Influence Collaborative at the University of Sydney’s Charles Perkins Centre examined the impact of resulting changes to transparency reporting requirements.
Reporting of spend in decline
Analysis of over 900 transparency reports on pharmaceutical industry payments revealed a 34.1% reduction in disclosed spending to the Australian healthcare sector, by member companies of pharmaceutical trade association Medicines Australia, in the year after the changes were introduced.
“These changes allowed for reduced reporting of spending on food and beverages at events and for sponsored healthcare professionals, with the result that over a third of previously reported industry spending on healthcare professionals is now hidden,” said co-author Dr Lisa Parker, from the University of Sydney School of Pharmacy.
Past studies have shown that even the provision of modest meals at such educational events hosted by pharmaceutical companies can influence prescribing behaviour of healthcare professionals, so the reduced transparency around pharmaceutical industry spending on food is a cause for concern.
“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,” Dr Parker added.
“There is one positive change: companies now report the names of individual health professionals who receive payments.
“However, the changes to the Code have added an extra layer of complexity as payments are scattered in more databases and the data in each of them is difficult to understand. This is hindering transparency when there is increasing societal interest in disclosure.”
Wakeup call for governments and regulators
Co-author Professor Lisa Bero – group lead of the Evidence, Policy and Influence Collaborative and from the School of Pharmacy – said the findings should act as a wakeup call to Australian governments and regulators.
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.
“Self-regulated transparency enables voluntary reporting and fails to regulate companies that are not members of the relevant industry body,” Professo Bero added.
Mandatory disclosure by pharmaceutical industry recommended
“We propose mandatory disclosure on spending,” said Professo Bero.
“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.”