In June 2012, the “code on disclosure of transfers of value from pharmaceutical companies to healthcare professionals and healthcare organisations” was announced by the European Federation of Pharmaceutical Industries and Associations (EFPIA). Starting 1 July 2016, the Association of the British Pharmaceutical Industry (ABPI) will publish details of British pharmaceutical company payments made to healthcare professionals, including nurses and pharmacists.
This goes beyond the US Physician Payment Sunshine Act, which doesn’t require companies to publicly report payments to nurse practitioners or physician assistants, even though they are allowed to write prescriptions in most states (see here). This, however, may change if legislation proposed by Sen. Charles Grassley, R-Iowa, and Sen. Richard Blumenthal, D-Conn., becomes law. The legislation would expand the disclosure requirement beginning in 2017 to include physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives (read more about that here).
What do UK health professionals think of ABPI's plans to publish these data?
Yesterday, I interviewed Thomas P. Stossel, M.D., visiting scholar at the American Enterprise Institute for Public Policy Research, about his new book, PharmaPhobia, and his call to action against the "Conflict of Interest Movement," which he claims undermines American medical innovation. You can hear some of his main arguments in the following 5-minute audio snippet from that interview:
Stossel uses many combative terms to describe the focus of his critique. In his book and in the interview, Stossel repeatedly refers to the "Conflict-of-Interest Movement," "Conflict-of-Interest Narrative," and conflict-of-interest "instigators, enablers and enforcers.”
Here's a sample of his acerbic style: “The case underlying the conflict-of-interest movement is a mixture of moralistic bullying, opinion unsupported by empiric evidence, speculation, simplistic and distorted interpretations of complicated and nuanced information, superficially and incompletely framed anecdotes, inappropriately extrapolated or irrelevant psychological research results, and emotionally laden human-interest stories.”
Tell us what you REALLY think Dr. Stossel! To me this sounds like every pharmaceutical marketing campaign, especially the part about "emotionally laden human-interest stories" (read, for example, "Online e-Patient & Celebrity Patient Video Testimonials").
But will Stossel's new book, which ends with a section on "What is to be done," turn the tide as he hopes it will?
On September 30, 2014, CMS published data records containing 4.4 million payments valued at nearly $3.7 billion in payments and transfers of value made to physicians and teaching hospitals in the last five months of Calendar Year 2013. This includes ownership or investment interests in applicable manufacturers and GPOs (group purchasing organizations) held by physicians or their immediate members, in addition to payments provided for research activities, gifts, speaking fees, meals, or travel.
These and other data are available to peruse using the "Data Explorer" tool on the OpenPaymentsData.CMS.gov website.
I recently used this tool to find out more about the types of payments big pharma companies make to physicians. I only looked at payments for items/services unrelated to research and ownership of stock; i.e., marketing-related items/services, which include
Food and Beverage
Consulting
Charitable Contributions
Education
Grants
Honoraria
Speaker Fees
Travel and Lodging
Unfortunately, I could not download the entire database because the number of records exceeds Excel's limit. Instead, I downloaded data for six specific pharma companies to perform my analysis. Although the result may not be representative of the entire drug industry, it does show how different companies dole out the dough to docs.
*The six companies I chose for my analysis include several with the highest yearly global sales:
