[1]images of money flickr creative commons
To disclose or not to disclose, that is the question.
A new survey of UK health providers finds that an overwhelming majority of those queried – 87 percent – believe that payments from drug makers should be transparent. And 69 percent who currently have a relationship with at least one drug company say they have given – or are likely to give – permission to have payment information disclosed.
The survey [2] was conducted by the Association of the British Pharmaceutical Industry, which last year began publishing aggregated payments to doctors and, next year, will publish certain detailed fees. The move to disclose some payments came as part of an updated industry code of conduct, which occurred following concerns about financial ties between providers and companies.
“This project is another step on our journey towards greater transparency, which will allow patients and others to fully understand our relationships,” said Virginia Acha, an ABPI executive director, in a statement. [3] The trade group queried 507 doctors, nurses, hospital specialists, and pharmacists.
Nonetheless, there is still some resistance.
Thirty-two percent believe it is unnecessary for drug makers to disclose payments to individual health care providers, and 26 percent feel disclosure will adversely affect medical innovation. Meanwhile, 75 percent said disclosure will not affect their relationships with industry, although 23 percent of general practitioners said they will be less likely to work with drug makers if payment data is published. By contrast, 17 percent of hospital specialists felt similarly.
The issue has generated considerable attention, especially in the United States, where a federal database called Open Payments launched last year. The Centers for Medicare & Medicaid Services created the database in response to a US Senate investigation several years ago that raised questions about undue influence drug and device makers may have on medical practice and research.
Although critics of the Open Payments database regularly expressed concern that disclosure would dissuade many physicians from participating in research, there is no indication, to date, to suggest this has happened.
The United Kingdom has trailed in mandating disclosure thanks to the ABPI, which has tried to get ahead of the curve and ward off government requirements. But the UK government may require disclosures after an undercover newspaper investigation [4] this summer showed drug makers allegedly paid National Health Service staffers to use specific medicines.
Elsewhere, Australian regulators recently approved a new code of conduct [5] for the pharmaceutical industry that requires drug companies to disclose payments made to physicians for speaking and consulting, as well as travel. The effort was resolved after a protracted row over a proposal to allow doctors to opt out. This would have meant specific payment data would not have appeared, but the idea was scrapped.