Transparency reporting by the pharmaceutical industry is in decline, warn Australian researchers who are calling for mandatory disclosure
And increased prescribing of unnecessary and costly medicines is one significant potential consequence of pharma company spending on events about their products, and payments to individual health professionals, health consumer groups and third parties such as hospitals, they say.
Dr Lisa Parker from the University of Sydney School of Pharmacy and Professor Lisa Bero, group lead of the Evidence, Policy and Influence Collaborative and from the School of Pharmacy, examined the impact of changes to transparency reporting requirements following updates of Australian pharmaceutical industry Codes of Conduct in 2015.
They analysed more than 900 transparency reports on pharma industry payments, and found a 34.1% reduction in disclosed spending to the Australian healthcare sector by Medicines Australia member companies, 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 Dr Parker.
“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.
“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,” Dr Parker added.
Prof Bero says 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,” Professor Bero said.
“Self-regulated transparency enables voluntary reporting and fails to regulate companies that are not members of the relevant industry body.
“We propose mandatory disclosure on spending. 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,” Prof Bero says.
Immediate past Chair of the RACGP Expert Committee – Quality Care Dr Evan Ackermann told newsGP that he welcomed the findings, saying the research “shines a light on the real world impact of political decisions”.
“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.”
A spokesperson for the Pharmacy Guild told newsGP and the AJP that the self-regulation of educational activities in the pharmaceutical industry should be “rigorous and transparent”.
“The regime implemented by Medicines Australia over past years has been robust,” they said.
“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.”