01.Full disclosure demanded
Medicines Australia, the main peak body representing pharmaceutical companies, has recently submitted its 18th Code of Conduct to the Australian Competition and Consumer Commission for approval.
But consumer advocates, including Dr Ken Harvey, are not satisfied that the code addresses one of the major issues affecting consumers – that is, transparency of transactions between drug companies and medical professionals.
What CHOICE wanted was an easily searchable database of the type and value of gifts provided by drug companies to doctors. If a doctor prescribes a particular medicine or device (such as an implant or prosthesis), we feel it’s important for consumers to be aware of any factors that may have influenced this decision.
Dr Harvey established a petition in 2012 signed by more than 450 people and organisations – including CHOICE – in favour of improving transparency around payments to individual healthcare professionals, arguing comprehensive disclosure of payments to health professionals by the pharmaceutical industry should be included in the Medicines Australia Code of Conduct.
Although the demands were not met, the ACCC limited its authorisation the 17th edition of the Medicines Australia Code of Conduct to two years rather than the five years sought, with the view to improving transparency provisions in the 18th edition.
However, the desired changes in the 18th edition did not eventuate.
While Medicines Australia has cracked down on small gifts, the proposed system of disclosure, as spelt out in the 18th Code of Conduct, will be self-regulated by the industry and allow doctors to opt out. Those who feel their independence could be considered compromised by their gifts will no doubt consider opting out of disclosure.
As Greens senator Richard Di Natale has noted, “The voluntary nature of disclosure makes the code next to meaningless. It’s like making a breathalyser voluntary for drink drivers”.
In an article published this week in the Medical Journal of Australia, Dr Harvey contends that the main reason the code is so weak is because other therapeutic goods industry associations (for example, the Generic Medicines Industry Association) have no transparency provisions in their codes. Further, there is an increasing number of pharmaceutical companies (especially generic companies based in India) who choose not to join therapeutic goods industry associations and are therefore not bound by any self-regulatory code.
So it's not surprising that many members of Medicines Australia were worried that attempting to force full disclosure would put them at a competitive disadvantage with other therapeutic goods companies, especially generic companies.
CHOICE has previously noted the issue of pharma company-sponsored gifts (for example, pens and computers), speaking and advisory board fees, and experiences (for example, dinners or travel to exotic locations for conferences). These gifts often come as part of the information dissemination process, where drug companies inform medical professionals about their latest products.
As well as keeping the brand name top of mind, however, psychological studies have shown that receiving even small gifts drives recipients to reciprocate, in this case perhaps by prescribing a particular drug over another equally appropriate one.
While collaborations between industry and health professionals are desirable, widespread financial ties bring significant risks of undue influence on professional judgements, potentially jeopardising the integrity of medical research, education, clinical practice and public trust in medicine.
Dr Harvey is encouraging concerned consumers to make a submission to the ACCC, as CHOICE has already done. Submissions close 1 August.