Exclusive: Payments included $6.5m for travel and accommodation and more than $4.2m in speaking and consultancy fees The drug companies that spent the most on health professionals in Australia were Bristol-Myers Squibb, Amgen, Sanofi, Pfizer and Bayer. Pharmaceutical companies gave Australian doctors, nurses and pharmacists almost $12m in fees and expenses to attend conferences and give talks between November 2016 and April 2017. The payments comprised more than $6.5m for travel expenses and accommodation; more than $4.2m in speaking and consultancy fees; and more than $700,000 to cover registration at medical conferences and events. The drug companies Bristol-Myers Squibb and Amgen both spent more than $1m over the six months and one doctor received more than $39,000. Health economists Prof Philip Clarke from the University of Melbourne and Dr Barbara de Graaff from the Menzies Institute for Medical Research in Tasmania conducted an analysis for Guardian Australia on the $11,667,253 in pharmaceutical payments made to healthcare professionals. Under the updated Medicines Australia code of conduct, pharmaceutical companies were required to disclose all payments made to healthcare professionals by 29 August. Previously, this disclosure required the consent of the health practitioners, which in many cases was withheld. The data is uploaded by each pharmaceutical company but not aggregated, making it difficult to see the whole picture of such payments. The researchers had to consolidate data from 35 company websites to run their analysis. “While disclosure is a good initiative, it’s hard to see how these data could be easily accessed,” said Clarke, who is the director of the Centre for Health Policy at the University of Melbourne’s school of population and global health. “This contrasts with other countries such as United States, which has an online database of all payments that can be searched by anyone.” Clarke and de Graaff found that the top 1% of the 4,500 healthcare professionals who receive payments in cash or in kind got 8.6% of all funds. That amounted to just over $1m, or on average $21,500 each over the six-month period. In contrast the bottom 50% received an average of $540 each. Clarke said countries such as the US were “streets ahead” of Australia when it came to reporting pharmaceutical company payments to doctors. The US Sunshine Act came into effect in 2013, making public the relationship between drug and medical device companies and healthcare professionals. In Australia medical device companies are not required to disclose payments to health professionals. Cochlear Australia, for example, which manufactures hearing implant devices, appears in the US database as making more than $133,000 in payments to US physicians but is not required to disclose the equivalent information in Australia. “I don’t see why device manufacturers aren’t disclosing, which is a mystery to the Australian system. I don’t see why politicians aren’t pushing to have something like the Sunshine Act implemented here, which received bipartisan support in the US.” The drug companies that spent the most on health professionals in Australia in the six months to April were Bristol-Myers Squibb ($1.34m), Amgen ($1.27m), Sanofi ($945,182), Pfizer ($819,946) and Bayer ($809,365). Clarke also wants to see any funding given by pharmaceutical and medical device companies to research institutions, including those attached to universities and hospitals, made public on a centralised database. The top 10 health professionals to receive pharma funding were all medical doctors or specialists and included a neurologist, a tobacco treatment specialist and an endocrinologist. Guardian Australia has decided not to name those doctors but the top “earner” received more than $39,000 in the six months. The average payment to the health professionals, who were largely general practitioners, specialists, nurses, pharmacists and professors, was $2,529. In a statement Medicines Australia said payments from pharmaceutical companies to health professionals helped to support continuing education and enabled doctors to “acquire the appropriate understanding and knowledge of new innovative therapies”. Medicines Australia also encourages consumers to talk to their doctors if they want to know more about their relationships with different companies, including the benefits of these relationships to patient health. But Dr Martin Tattersall, an eminent Sydney cancer specialist known for rejecting visits from pharmaceutical companies, told Guardian Australia this was “a nice idea in theory”. “This education is mostly biased information if it’s coming from pharma,” he said. “Many of them are basically the industry sponsoring their choice of presenter to do things which may be in the interest of the company rather than the patient. So much continuing medical education these days is sponsored by industry.” Tattersall said many health professionals, especially doctors, could claim medical conferences at tax time and were often given leave allowances by their workplaces for conferences and further study, making accepting payments for education and travel to medical events from industry unnecessary. A study led by Tatterall and published in the Medical Journal of Australia found the majority of patients (71%) wanted to know if their doctor obtained any benefits in cash or kind from the pharmaceutical industry. “I’m rather critical of some of my colleagues who take advantage of sponsorship in a major way,” he said. “For me, I pay my own way and never accept sponsorship. But I find that going to specialist conferences of my choosing is a better use of time than going to big pharmaceutical-sponsored jamborees.” Source
