Drug corporations are paying Australian doctors thousands and thousands of dollars a 12 months to fly to overseas conferences and meetings, give talks to other doctors, and to serve on advisory boards, our research shows.
Our team analysed reports from major drug corporations, in the primary comprehensive evaluation of its kind. We found drug corporations paid greater than A$33 million to doctors within the three years from late 2019 to late 2022 for these consultancies and expenses.
We know this underestimates how much drug corporations pay doctors because it leaves out the most typical gift – foods and drinks – which drug corporations in Australia don’t declare.
Due to COVID restrictions, the timescale we checked out included periods where doctors were prone to be travelling less and attending fewer in-person medical conferences. So we suspect current levels of drug company funding to be even higher, especially for travel.
What we did and what we found
Since 2019, Medicines Australia, the trade association of the brand-name pharmaceutical industry, has published a centralised database of payments made to individual health professionals. This is the primary comprehensive evaluation of this database.
We downloaded the info and matched doctors’ names with listings with the Australian Health Practitioner Regulation Agency (Ahpra). We then checked out what number of doctors per medical specialty received industry payments and the way much corporations paid to every specialty.
We found greater than two-thirds of rheumatologists received industry payments. Rheumatologists often prescribe expensive latest biologic drugs that suppress the immune system. These drugs are answerable for a substantial proportion of drug costs on the Pharmaceutical Benefits Scheme (PBS).
The specialists who received probably the most funding as a bunch were
cancer doctors (oncology/haematology specialists). They received
over $6 million in payments.
This is unsurprising given recently approved, expensive latest cancer drugs. Some of those drugs are wonderful treatment advances; others offer minimal improvement in survival or quality of life.
A 2023 study found doctors receiving industry payments were more prone to prescribe cancer treatments of low clinical value.
Our evaluation found some doctors with many small payments of a couple of hundred dollars. There were also instances of huge individual payments.
Why does all this matter?
Doctors normally consider drug company promotion doesn’t affect them. But research tells a special story. Industry payments can affect each doctors’ own prescribing decisions and people of their colleagues.
A US study of meals provided to doctors – on average costing lower than US$20 – found the more meals a physician received, the more of the promoted drug they prescribed.
El Nariz/Shutterstock
Another study found the more meals a physician received from manufacturers of opioids (a category of strong painkillers), the more opioids they prescribed. Overprescribing played a key role within the opioid crisis in North America.
Overall, a considerable body of research shows industry funding affects prescribing, including for drugs that usually are not a primary alternative due to poor effectiveness, safety or cost-effectiveness.
Then there are doctors who act as “key opinion leaders” for corporations. These include paid consultants who give talks to other doctors. An ex-industry worker who recruited doctors for such roles said:
Key opinion leaders were salespeople for us, and we would normally measure the return on our investment, by tracking prescriptions before and after their presentations […] If that speaker didn’t make the impact the corporate was in search of, then you definately wouldn’t invite them back.
We learn about payments to US doctors
The best available evidence on the results of pharmaceutical industry funding on prescribing comes from the US government-run program called Open Payments.
Since 2013, all drug and device corporations must report all payments over US$10 in value in any single 12 months. Payment reports are linked to the promoted products, which allows researchers to check doctors’ payments with their prescribing patterns.
Analysis of this data, which involves tons of of hundreds of doctors, has indisputably shown promotional payments affect prescribing.
LightField Studios/Shutterstock
US research also shows that doctors who had studied at medical schools that banned students receiving payments and gifts from drug corporations were less prone to prescribe newer and dearer drugs with limited evidence of profit over existing drugs.
In general, Australian medical faculties have weak or no restrictions on medical students seeing pharmaceutical sales representatives, receiving gifts, or attending industry-sponsored events during their clinical training. They also don’t have any restrictions on academic staff holding consultancies with manufacturers whose products they feature of their teaching.
So a primary step to forestall undue pharmaceutical industry influence on prescribing decisions is to shelter medical students from this influence by having stronger conflict-of-interest policies, comparable to those mentioned above.
A second is healthier guidance for individual doctors from skilled organisations and regulators on the varieties of funding that’s and is just not acceptable. We consider no doctor actively involved in patient care should accept payments from a drug company for talks, international travel or consultancies.
Third, if Medicines Australia is serious about transparency, it should require corporations to list all payments – including those for foods and drinks – and to link health professionals’ names to their Ahpra registration numbers. This is analogous to the reporting standard pharmaceutical corporations follow within the US and would allow a more complete and clearer picture of what’s happening in Australia.
Patients trust doctors to decide on the most effective available treatments to fulfill their health needs, based on scientific evidence of safety and effectiveness. They don’t expect marketing to influence that alternative.
