Pharmaceutical industry self-regulation and non-transparency: country and company level analysis of payments to healthcare professionals in seven European countries

Mulinari, Shai; Martinon, Luc; Jachiet, Pierre-Alain; Ozierański, Piotr

doi:10.1016/j.healthpol.2021.04.015

Cited by 33 publications

(67 citation statements)

References 17 publications

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“…Therefore, Disclosure UK should include payment descriptions–similar to those already provided in the self-regulatory arrangements for payments to patient organisations [ 65 ]–to illuminate payments’ intended goals. Similarly, without recipient identifiers data users are unable to establish the level of exposure of any practice to drug company payments [ 11 , 19 ]. Consequently, Disclosure UK should introduce identifiers already used by the NHS (i.e., practice codes), which would also allow for linking payment data to other publicly available datasets.…”

Section: Discussionmentioning

confidence: 99%

“…Research on payment disclosures has centered on individual healthcare professionals [ 8 – 11 ], with increasing evidence from the US of even small payments influencing drug prescription [ 12 – 14 ] and healthcare cost [ 14 , 15 ]. However, healthcare organisations (HCOs), including service providers, regulators or medical societies, have received less attention, even though they shape healthcare delivery via resource allocation, regulatory decisions, recommendations and guidelines [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, pharmaceutical companies and trade groups typically do not interpret payments to HCOs as falling under European data privacy laws, which prevents these recipeints from refusing to have their payments disclosed [ 17 ]. This contrasts with payments to healthcare professionals, interpreted by the industry as “personal data”, and therefore characterised by pervasive non-disclosure, precluding comprehensive analysis [ 11 ]. For example, in 2015 in the UK, only around 50% of the disclosed payments had any information about the individual recipients [ 10 ], and this had increased only to about 60% by 2019 [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…This contrasts with payments to healthcare professionals, interpreted by the industry as “personal data”, and therefore characterised by pervasive non-disclosure, precluding comprehensive analysis [ 11 ]. For example, in 2015 in the UK, only around 50% of the disclosed payments had any information about the individual recipients [ 10 ], and this had increased only to about 60% by 2019 [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Drug company payments to General Practices in England: Cross-sectional and social network analysis

2021

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Although there has been extensive research on pharmaceutical industry payments to healthcare professionals, healthcare organisations with key roles in health systems have received little attention. We seek to contribute to addressing this gap in research by examining drug company payments to General Practices in England in 2015. We combine a publicly available payments database managed by the pharmaceutical industry with datasets covering key practice characteristics. We find that practices were an important target of company payments, receiving £2,726,018, equivalent to 6.5% of the value of payments to all healthcare organisations in England. Payments to practices were highly concentrated and specific companies were also highly dominant. The top 10 donors and the top 10 recipients amassed 87.9% and 13.6% of the value of payments, respectively. Practices with more patients, a greater proportion of elderly patients, and those in more affluent areas received significantly more payments on average. However, the patterns of payments were similar across England’s regions. We also found that company networks–established by making payments to the same practices–were largely dominated by a single company, which was also by far the biggest donor. Greater policy attention is required to the risk of financial dependency and conflicts of interests that might arise from payments to practices and to organisational conflicts of interests more broadly. Our research also demonstrates that the comprehensiveness and quality of payment data disclosed via industry self-regulatory arrangements needs improvement. More interconnectivity between payment data and other datasets is needed to capture company marketing strategies systematically.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Drug company payments to General Practices in England: Cross-sectional and social network analysis

2021

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“…4 The scrutiny of European payment data has been limited, except for case studies of payment distribution in the UK, 21 24 Germany 26 and Ireland, 27 and a comparative analysis of payments shares not disclosed by recipients in the UK, Germany, Sweden, Switzerland, Italy, Ireland and Spain. 28 However, France is the sole country where relationships between payments and prescribing have been investigated. 29 Similarly, the potential for detecting organisational-level FCOIs is unrealised, with only two studies examining discrepancies in payments reported separately by companies and some healthcare providers 30 and commissioners 31 in England.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Accessibility and quality of drug company disclosures of payments to healthcare professionals and organisations in 37 countries: a European policy review

et al. 2021

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ObjectivesTo examine the accessibility and quality of drug company payment data in Europe.DesignComparative policy review of payment data in countries with different regulatory approaches to disclosure.Setting37 European countries.ParticipantsEuropean Federation of Pharmaceutical Industries and Associations, its trade group and their drug company members; eurosfordocs.eu, an independent database integrating payments disclosed by companies and trade groups; regulatory bodies overseeing payment disclosure.Main outcome measuresRegulatory approaches to disclosure (self-regulation, public regulation, combination of the two); data accessibility (format, structure, searchability, customisable summary statistics, downloadability) and quality (spectrum of disclosed characteristics, payment aggregation, inclusion of taxes, recipient or donor identifiers).ResultsOf 30 countries with self-regulation, five had centralised databases, with Disclosure UK displaying the highest accessibility and quality. In 23 of the remaining countries with self-regulation and available data, disclosures were published in the portable document format (PDF) on individual company websites, preventing the public from understanding payment patterns. Eurosfordocs.eu had greater accessibility than any industry-run database, but the match between the value of payments integrated in eurosfordocs.eu and summarised separately by industry in seven countries ranged between 56% and 100% depending on country. Eurosfordocs.eu shared quality shortcomings with the underlying industry data, including ambiguities in identifying payments and their recipients. Public regulation was found in 15 countries, used either alone (3), in combination (4) or in parallel with (8) self-regulation. Of these countries, 13 established centralised databases with widely ranging accessibility and quality, and sharing some shortcomings with the industry-run databases. The French database, Transparence Santé, had the highest accessibility and quality, exceeding that of Disclosure UK.ConclusionsThe accessibility and quality of payment data disclosed in European countries are typically low, hindering investigation of financial conflicts of interest. Some improvements are straightforward but reaching the standards characterising the widely researched US Open Payments database requires major regulatory change.

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Funding of Clinical Trials Through Non-Profit and Third-Party Organizations: A Case Study of the CREATE-X Trial in Japan

Ozaki

Murayama²,

Tanimoto³

2022

Integrity of Scientific Research

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Pharmaceutical industry self-regulation and non-transparency: country and company level analysis of payments to healthcare professionals in seven European countries

Cited by 33 publications

References 17 publications

Drug company payments to General Practices in England: Cross-sectional and social network analysis

Drug company payments to General Practices in England: Cross-sectional and social network analysis

Accessibility and quality of drug company disclosures of payments to healthcare professionals and organisations in 37 countries: a European policy review

Funding of Clinical Trials Through Non-Profit and Third-Party Organizations: A Case Study of the CREATE-X Trial in Japan

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