Total spend
on consultancy fees and junkets by 35 suppliers revealed by trade body in move
to greater transparency
The Guardian, Sarah Boseley, health editor, Friday 5 April 2013
 |
Doctors deny that taking money from pharmaceutical companies influences
their judgment about what medicine to prescribe. Photograph: Paul Hardy/Corbis |
Drug
companies are paying an estimated £40m a year to British doctors in service
fees, flights, hotel and other travel expenses, according to the trade body
that represents pharmaceutical companies.
The
Association of the British Pharmaceutical Industry (ABPI) said that most of the
44 biggest companies had now revealed how much they paid doctors to help market
their drugs. Its aggregated total of £40m is based on 35 suppliers who have
shared precise information with the body and estimates for the rest.
The largest
British group, GlaxoSmithKline, spent £1.9m on fees for advice and consultancy
on 1,517 UK-based doctors, an average of £1,252 each. It also sponsored 1,022
doctors and other healthcare professionals to attend scientific conferences and
meetings, at a total cost of £887,294 – an average of £868 per trip.
Doctors
have always denied that taking drug company money influences their judgement in
any way about a medicine, but suspicions have lingered.
Doctors
sometimes ask for sponsorship to go to international meetings, which they argue
they need to attend to keep up with developments in their field. Their
hospitals cannot afford to pay their flights and hotel bills, they say.
Thousands
of doctors have their flights, registration fees and hotels paid for when they
attend major international conferences on cancer or cardiology. They are
transported to top restaurants by their sponsoring company and socialise with
its staff. Many of the speakers who take to the platform to talk about the
benefits of new medicines are senior doctors who are earning a consultancy fee
from a pharmaceutical firm.
AstraZeneca,
the other major British company, separates out the payments from its UK office
and those from its "global teams and international affiliates". The
UK office paid £671,400 in fees to 903 doctors plus £30,200 for their travel
and hotel bills. Some doctors carried out more than one engagement. Their
average earnings including expenses came to £776.96.
But those
who were paid by the global teams did far better. A total of £563,000 including
expenses was paid out to 93 individuals, giving an average of £6,053.76.
However, the 93 people were involved in 304 activities, which gave them an
average fee, including expenses, of £1,851.97.
Unlike
AstraZeneca, GSK said it had added in payments from its offices abroad, because
many of the doctors who receive payment for advice and consultation are global
experts.
AstraZeneca,
however, did not sponsor any doctors to go to conferences in 2012, a major
departure for a pharmaceutical company, because the bad publicity surrounding
drug company junkets made it rethink its policy.
In 2005,
the Commons health select committee warned in a report that the industry's
sponsorship of doctors and other medical staff had drug promotion as its motive
and could lead to the unsafe prescribing of drugs such as Vioxx, the arthritis
drug which was found to cause heart attacks.
AstraZeneca
only supports "a limited number of doctors to attend international
conferences in connection with contracted services", it said, which means
they would earn fees for speaking rather than being sponsored to listen.
It said it
was not offering lavish expenses. "We have embedded robust controls in our
process for supporting travel and accommodation to ensure that it is only
provided in a lawful manner that is consistent with our commitment to
integrity," AstraZeneca said.
Andrew
Powrie-Smith, director of the ABPI, said he did not think having to publish
what the pharmaceutical industry spent on doctors would tend to make most
companies less generous.
Powrie-Smith
said: "Industry in the UK is proud of its collaboration with health
professionals. A fifth of the top 100 medicines in the UK have come from this
collaboration. But there is increasing demand for transparency in the
relationship. I don't see that it will have a particularly negative impact over
their willingness to support medical education."
At the
moment, drug companies are only required to publish their total outlay on doctors.
By 2016, however, the European trade body is expecting them to publish the
names of the individual doctors they pay. If this happens, the industry will
have moved further and faster than the NHS on transparency. All hospital trusts
are supposed to keep a register of payments to their staff in case of conflicts
of interest, but not all are complete and they are not always available to the
public.
The ABPI
agreed in 2010 that all companies would publish their total payments to
healthcare professionals.
