Pharmaceutical companies will be required to disclose more details about their financial ties to doctors under a revised self-regulatory code, but they have resisted calls to name doctors individually or reveal how much they pay them.
Medical experts say the latest revision to the Medicines Australia Code, submitted to the ACCC yesterday, does not go far enough to promote transparency in dealings between the pharmaceutical industry and health professionals. They also criticise the decision not to increase the maximum fine for code offences – $250,000, or $300,000 for repeated violations – regarded by many to be an insufficient deterrent.
Under the revision, which comes into effect in January next year, pharmaceutical companies must disclose aggregate payments to all doctors for consultancies, speaking engagements, advisory duties and sponsorships to attend education seminars. Companies will also be required to publicise payments to patient support groups.
The code includes a ban on drug-branded goods such as mugs and pens, as well as all personal gifts to doctors.
But Medicines Australia said it had decided against mandating the release of all financial links to individual doctors over concerns about privacy, and because the cost of overseeing such a scheme, similar in effect to the Physician Payment Sunshine Act in the United States, would be prohibitive.
Medicines Australia CEO, Dr Brendan Shaw, said the peak body was “serious about maintaining an ethical industry that adds value to the role doctors play in treating patients and curing disease.”
He said Medicines Australia was mindful that disclosing the names of individual doctors could also trigger witch hunts. Instead, it would assemble a working group of representatives from both industries to consider ways to increase transparency.
Some medical experts said the regulatory body was moving too slowly.
“If we don’t name who we’re paying money to, then we’re not really behaving maturely in this area,” said Jon Jureidini, a Professor of Psychiatry at the University of Adelaide who played a crucial role in exposing the illegal behaviour of drug company GlaxoSmithKline in a major case in the US this week. The pharmaceutical group admitted bribing doctors and must pay US authorities $3 billion for fraudulently promoting antidepressant drugs for the treatment of children, without revealing research linking the drug to suicidal thoughts.
“We’ve got to be completely open about what money changes hands down to the dollar,” Professor Jureidini said. “The average fine in Australia is $50,000. That’s not going to hurt a drug company that’s worth hundreds of millions of dollars.”
Ian Kerridge, Associate Professor in Bioethics, and Director of the Centre for Values and Ethics and the Law in Medicine at the University of Sydney, said that although the revision “does continue the incremental improvements in transparency and control of the pharmaceutical industry … there is a continued inadequacy of any type of punishment mechanism within the code.
“And the other thing that disturbs me is the continuing failure to provide absolute transparency regarding the amount of sponsorship money or reimbursement given to individual doctors and researchers.
“Without that transparency, any type of reporting is quite meaningless. They’ve given a commitment to look at that issue, but they’ve been looking at it for an awfully long time. It’s just obfuscation, it’s delaying.”