Australian reporting standards for disclosing the ties between pharmaceutical companies and health professionals are not comprehensive enough, according to an analysis in this week's PLoS Medicine.
David Henry (Institute for Clinical Evaluative Sciences, Toronto, Canada) and colleagues reviewed data disclosed by Medicines Australia, the pharmaceutical industry representative body, which since mid-2007 has been required to report the details of every industry-sponsored function and educational event for health professionals. Despite the fact that Australian pharmaceutical companies have to disclose details about the venue and total cost of an event they sponsor, as well as its attendees and the hospitality offered, they still do not have to declare the names of speakers at these events, the financial ties between companies and speakers, and the role that companies played in speaker selection.
The analysis showed that there were around 600 industry-sponsored events per week across Australia in 2007. Thirty-five percent of the sponsored events were held in restaurants, hotels or function centres – hospitality (food, beverages and accommodation) accounted for $17 million Australian dollars of the $31 million spent on functions. Oncologists and psychiatrists were the medical subspecialists most frequently hosted at events (17.8 and 15.2% respectively); family physicians were at a third of the events and nurses at a quarter. Although expenditure at individual events was often modest, the cumulative expenditure was high, particularly on medical specialists prescribing high-cost drugs – oncologists and cardiologists received the highest per head expenditure. Henry and colleagues therefore argue that setting a dollar threshold below which details of industry-sponsored events do not need to be disclosed, as is the case in some American states, is not adequate for transparency. "It is not only the size of the gift that matters," they say, "it is the sense of reciprocity it engenders."
The authors argue that the Australian reporting standards do not do enough to allow assessment of educational content of industry-sponsored events, a particular concern because doctors can be awarded continuing medical education points at these events. The authors recommend that the role of the company in suggesting the educational topic and event speakers must be revealed. They conclude that whilst it might be unrealistic to ban all contact between pharmaceutical companies and health professionals, more work is required to "make those relationships completely transparent."
Funding: No specific funding was received for this study.
Competing Interests: DH appeared as a witness for the Australian Competition and Consumer Commission at the Tribunal held at the Federal Court in Sydney in June 2007. All other authors have no competing interests to declare.
Citation: Robertson J, Moynihan R, Walkom E, Bero L, Henry D (2009) Mandatory Disclosure of Pharmaceutical Industry-Funded Events for Health Professionals. PLoS Med 6(11): e1000128. doi:10.1371/journal.pmed.1000128
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CONTACTS:
David Henry
Institute for Clinical Evaluative Sciences
Sunnybrook Health Sciences Centre
Torono, Ontario M4N 3M5
Canada
+1 416 371 6947
david.henry@ices.on.ca
Ray Moynihan
University of Newcastle
School of Medicine and Public Health
Newcastle, New South Wales 2308
Australia
ray.moynihan@newcastle.edu.au
Lisa Bero
University of California San Francisco
Department of Clinical Pharmacy
San Francisco, CA 94143
United States of America
+1 415 476 1067
+1 415 502 0792 (fax)
berol@pharmacy.ucsf.edu
Journal
PLoS Medicine