Healthy Skepticism Library item: 1318

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Burton B.
Gov't wants drug companies to reveal doctors junkets
Inter-Press Service 2003 Jun 28

Full text:

CANBERRA, (IPS) In what is likely to be a world first, the Australian government’s consumer protection agency has proposed that major drug companies be required to publish on a website details of all offers they have made to sponsor doctors’ travel, accommodation and other promotional benefits.

The proposed disclosure requirements would not only affect overseas trips of Australian doctors, but those of doctors in the Asia-Pacific region being sponsored by Australian companies, including on trips to events in Australia. According to a spokeswoman for the ACCC the proposal would require disclosure by Australian based drug companies along with deals offered by their overseas head offices for events in and outside Australia.

Senior Policy Officer with the Australian Consumers Association, Martyn Goddard, welcomes the proposals as a step forward. “The drug companies are global so they may well have an office in Britain but they will also have also got an office in Sydney so if they ask a doctor in Adelaide to go to Aberdeen in Scotland then that will be handled through the Sydney office and bang it goes up on the website. This requirement is really going to cut down these sorts of inappropriate marketing deals,” he said.

While the Asia-Pacific market currently accounts for only US$25 billion of the US$351 billion global pharmaceutical industry, the Australian offices of the global drug companies aiming to supply an increasing share of the regional pharmaceutical market. A session on the ‘marketing challenges’ in the Asia-Pacific region at a mid-May conference on pharmaceutical marketing in Sydney suggested that Korea, Taiwan and Singapore were viewed as markets that were ‘taking off’.

China and India – while having large population bases – were classed as ‘awakening’ markets due to their current heavy reliance on generic off-patent drugs rather than the more expensive and profitable brand name drugs manufactured by global drug companies.

The ACCC proposal follows public revelations two years ago of an ‘educational’ meeting for 270 doctors aboard a cruiseboat on Sydney Harbour. Along with the lectures on drug treatments for heart disease the assembled doctors were treated to a floorshow replete with dancing girls.

At other meetings doctors were also revealed being courted by drug companies with lavish dinners at top restaurants.

Stung by the adverse publicity, the industry proposed to tighten up its self-regulatory code. In assessing the application to the ACCC by Medicines Australia – the peak drug industry lobbying association – the regulator sought advice from consumer and doctors groups.

In issuing it’s draft ruling, the ACCC echoes some of their concerns. “… Doctors’ prescribing habits are likely to be influenced by the provision of benefits by pharmaceutical companies. Where this results in doctors prescribing medicines, which are not the most appropriate choice for their patient (according to the available scientific evidence), it is likely to harm patients,” the ACCC stated.

“The conditions will improve the Code’s ability to prevent drug companies’ marketing activities inappropriately influencing doctors’ prescribing decisions,” the ACCC said in a statement announcing the decision. The ACCC also proposed that Medicines Australia also be required to publish full details of all breaches of the Code on its website.

The director of the global public health group, Healthy Scepticism, Peter Mansfield, welcomes the proposals but believes they should have gone further. “There are little steps but the house is burning down there are little steps when we actually should be running,” he said. Mansfield, a general practitioner, believes that a better model would have been to have a web based system so that patients could look up their local doctors and see which ones had accepted gifts.

More problematic, he argues, is that while doctors attendance at educational meetings will be disclosed, what occurs in one-on-one meetings with the drug company sales representatives won’t be included. “I would have thought that is the highest risk. At least in a meeting there are other people around to see what is going on,” he said.

In a special theme edition in late May the prestigious British Medical Journal editorialised against the courting of doctors by drug companies.

“Sponsored conferences and compromised medical education. Courtesy golf and unaffordable holidays. Thought leaders and ghostwriters. These are the trappings of doctors and drug companies being entwined in an embrace of avarice and excess, an embrace that distorts medical information and patient care,” the BMJ editors wrote.

Gooddard argues that the notion that the drugs should be tightly regulated but their promotion left to a self-regulatory system is farcical. “It really is up to the government to make sure that this area of medicine is regulated properly,” he said.

Steven Haynes, the Director of Strategic Relations for Medicines Australia said the organisation would respond after it has studied the 41-page draft determination more closely. The peak doctors organisations the Australian Medical Association and the Royal Australian College of General Practitioners were unavailable for comment. The draft proposal is now open for public comment and is likely to be finalised within the next two months.

Mansfield says he will be making a submission to encourage the ACCC to go further. Their proposal, he said, “is giving us another piece of the jigsaw puzzle but it is not going to be enough … we won’t have the full picture to work with”.