Payments to healthcare organisations reported by the medical device industry in Europe from 2017 to 2019: an observational study

Abstract

BackgroundMedical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. MedTech Europe, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system.MethodsAn observational study of education-related payments to HCOs reported by the medical device industry in Europe was conducted. Data was manually extracted from transparentmedtech.eu. The primary outcome variable is the value of the payments, overall, and for each year, payment type, and country. The accessibility, availability and quality of the database was also analysed, using a proforma with 15 measures.FindingsOverall, 116 medical device companies reported education-related payments in 53 countries, valuing over €420 million between 2017-2019, increasing in value between 2017-2019, from €91,289,672 to €175,414,302. Ten countries accounted for 94% of all payments and ten companies accounted for 80% of all payments. The accessibility, availability and quality of the database, rated low for six measures, medium for six measures and high for three measures.InterpretationThere is a large amount of education-related payments from medical device companies to European HCOs, creating substantial potential for conflicts of interest. MedTech Europe’s disclosure system has many shortcomings. A European-wide publicly mandated disclosure system for both the medical device and pharmaceutical industries should be introduced.FundingSwedish Research Council (SM, PO)

Drug company methodologies used for reporting in the UK pharmaceutical industry payment transparency database between 2015-2019: A content analysis

“…This study's findings of opacity in several areas corresponds with issues outlined in other studies of disclosure systems, such as non-disclosure of certain payment areas, 27 and unnecessary aggregation of recipients. 18,46 Overall, it reinforces the conclusions of the 2021 analysis of European disclosure systems, that "self-regulation cannot address 'the issues of perceived conflict of interest', as promised by EFPIA." 22 The shortcomings of self-regulation found here reflect issues with self-regulation generally, which can be seen in other areas of the pharmaceutical industry 47,48 and other industries including alcohol 49 and nutrition.…”

“…This study adds to the literature showing major shortcomings of self-regulated payment disclosure systems from both the pharmaceutical 1,18,22,44,45 and medical device 46 industries. This study's findings of opacity in several areas corresponds with issues outlined in other studies of disclosure systems, such as non-disclosure of certain payment areas, 27 and unnecessary aggregation of recipients.…”

“…For example, VAT should be included in all disclosures, where applicable, as is required by the European medical device industry. 46 For other areas, where different methodologies are permissible due to different business practices (e.g. exchange rates) adherence to the EFPIA template methodological note (Appendix, eBox 3) would improve interpretability.…”

Medical royal colleges receive millions from drug and medical devices companies

“…The BMJ also analysed data from a similar transparency initiative for medical device companies, Transparent MedTech, which is run by MedTech Europe, the European trade association for these firms 3. For the years 2017 (J Larkin, personal communication)4 to 2021, the most recent year with available data, companies declared total payment of £1.7m to royal colleges for “educational grants” and “support to educational events.”…”

Drug Promotions Between Ethics, Regulations, and Financial Interests

“…The pharmaceutical industry has tried over time to interest them, there are numerous examples of the level to which this phenomenon has risen; thus, in 1958, approximately 90% of Big Pharma's marketing was addressed to doctors, in 2012 the estimated amounts were $ 24 billion, and in 2017-2019 they reached EUR 420 million. 39,[102][103][104][105] According to some authors, in 2015, about 48% of all physicians in the United States received $2.4 billion, and over 67% of physicians received sponsorships from 2015 to 2017. 106,107 The techniques for influencing the therapeutic decision used in strategic marketing by pharmaceutical companies are very varied from the presentation of products at scientific events (conferences, workshops) often by people considered opinion leaders, accompanied or not by other facilities (payment of registration fees, free meals) or other facilities: payment of lecturers, sponsorship of clubs, etc.…”