Transparency in drug company payments to doctors

In a BMJ “briefing” Rebecca Coombes sums up the new UK system for public disclosure of payments from drug companies to doctors

Published the 2nd January 2015 in The BMJ, here follows the full article:

Transparency-in-drug-compan

I have met Andrew Powrie-Smith of the ABPI several times. He has made it a personal mission to improve transparency for the Pharmaceutical Industry and I applaud his efforts. My concern is that the medical profession may not yet quite agree with Powrie-Smith that transparency is a “societal expectation”. I say this as (1) the voluntary register Who pays this doctor? has not exactly been burdened with declarations, and (2) my research into Registers of interest for all staff employed in NHS Scotland has evidenced very poor compliance with Scottish Government Guidance (HDL 62).

The new database, set up by the ABPI, is a most positive development. We should however be aware that it only applies to the pharmaceutical industry and not other areas of commerce: such as device makers, nutritional supplements, digital technologies etc. It is my understanding that the ABPI Register also only applies to doctors. Do we not also need to consider academics, managers, commissioners, pharmacists, nurses, AHPs, charities all of whom could be paid to “educate” us about a specific condition and a product or test for this. Or to commission a service for it.

Surely however, the main issue with this new ABPI code is that it has no legal underpinning. Doctors can opt out of declaring any financial payments and they so they will not be named.

This is why I have petitioned the Scottish Government for a Sunshine Act (or clause). America has this legislation as do several other countries.

Opt-out

 

Freedom of Information Requests

Freedom of Information Requests have been made to all 14 NHS Boards in Scotland.

The requests asks for Register of payments from pharmaceutical companies to NHS staff. Requests are currently being processed and progress on all 14 NHS Boards Hospitality Registers can be found here: https://www.whatdotheyknow.com/user/peter_j_gordon/requests

Scottish Government Policy on ‘Guidance on Joint-Working between NHSScotland and the Pharmaceutical Industry’ was published 2nd November 2012: “A Common Understanding 2012 – Working Together For Patients” You can access it here: http://www.scotland.gov.uk/Publications/2012/11/2726/downloads

The initial letter sent to each individual NHS Board in Scotland:

Dear NHS Board,
Hospital Boards are reportedly meant to keep a register of payments  from pharmaceutical companies (and other relevant companies) to  staff, in case of conflicts of interest [1]. I am requesting a copy  of the register for this Board – which I would hope includes  details of all relevant payments to staff and any related potential  conflicts of interest. If it would be possible to have this  information in an appropriate structured data format – for example,  a CSV file – this would be helpful. If this Board does not have a  complete register, I would request: the release of the information  on this topic that the Board does hold; and an explanation of why  the Board does not hold a complete register.

I am aware that some would view data on pharmaceutical funding as  personal data for those staff receiving the funding. Even if some  of the information on this register may be classed as personal data  (although this is contestable – for example, in some sectors of  academia information re funding sources is made public as a matter  of course) it would be covered by paragraph 6 of Schedule 2 of the  Data Protection Act. The release of these data is “necessary for  the purposes of legitimate interests pursued by the data controller  or by the third party or parties to whom the data are disclosed” [2]. Spurling et al’s systematic review of how information from  pharmaceutical companies impacts physicians’ prescribing reported  that, of the studies included which looked at total promotional  investment, three “found that total promotional investment was  positively associated with prescribing frequency…Two…found both  positive results and no association…One study did not detect an  association” [3]. There is thus a legitimate interest in releasing  this register: the available research suggests that it is plausible  that payments received influence how public money is spent and the  type of care provided to members of the public.

For the reasons given above, there is a strong public interest in  releasing this information. While “requests for the personal data  of a third party are exempt under section 40(2) of the Freedom of  Information Act…if disclosure would contravene section 10 of the  Data Protection Act, the right to prevent processing likely to  cause damage or distress” [2], I would argue that, even if some of  those named in these documents feel that their release would cause  them damage or distress, this is outweighed by the significant  public interest served by releasing these data.

Yours Faithfully,
Dr Peter J. Gordon

14 NHS Boards