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Drug company promotion to doctors endemic in Australia: Potential influence of sponsored events revealed

An analysis of drug company-funded events in Australia has raised concerns about commercial influence. Researchers have created a searchable database providing valuable transparency following changes to disclosure requirements.

A world-first analysis of events funded by pharmaceutical companies targeting Australian doctors and health professionals suggests a pervasive commercial presence in everyday clinical practice.

The study, led by the University of Sydney’s Charles Perkins CentreBias in Research project node and involving Bond University Senior Research Fellow Dr Ray Moynihan, identified almost 3.5 million individual attendances at over 116,000 sponsored medical education events in the four-year period between 2011 and 2015.

Previous research has shown sponsored events are a key promotional strategy for the pharmaceutical industry, with clear associations between attending such events and prescribing higher-cost medicines.

The new Australian research, published in BMJ Open today, reveals nearly two thirds of events were held in a clinical setting, such as hospitals, clinics or doctors’ offices, indicating drug company promotion is endemic within the health system.

Food and beverages were almost always provided at the publicly reported events. Following recent changes to disclosure rules explicitly excluding food and beverages from reporting requirements, a large extent of industry-sponsored activities will likely disappear from public view.

Lead author and University of Sydney PhD student Dr Alice Fabbri said: “The sheer number of events reveals the extent of potential commercial influence over professional education. It’s particularly concerning given much of this information is soon likely to drop from public view.”

She urged decision makers to consider how to mitigate the impact of changes to disclosure requirements and added: “Transparency is important, but independence from industry would be much better. Of course ongoing education is essential for health professionals, but we need to consider alternative ways of funding it.”

The research team – from the University of Sydney, Newcastle University and Bond University – extracted data from over 300 PDF reports downloaded from the website of Medicines Australia, the pharmaceutical industry trade association.

They created a new searchable database to allow researchers, journalists and the public to more easily analyse the intersection of pharmaceutical marketing and medical education. Institutions such as hospitals and universities will also be able identify what industry-sponsored activities are happening, and whether they meet contemporary expectations for transparency and independence.

Other key findings of the study include:

  • Average costs were low, however more than 2,400 events reported costs of over $1,000 per attendee.
  • Cancer specialists, an area where there is ongoing concern about the use of very high-cost drugs, were targeted most often and present at almost 23,000 events.
  • Nurses were present at 40 percent of events, medical trainees at almost 40 percent and pharmacists at almost 10 percent.

Bond University Senior Research Fellow Dr Ray Moynihan said, “These results suggest a hidden epidemic of unhealthy influence on doctor’s decision-making. As we are more focused on decreasing harmful waste, we need increased transparency, not secret wining and dining.”

Professor Lisa Bero, from the University of Sydney’s Faculty of Pharmacy and leader of the bias node at the Charles Perkins Centre, said the findings of the study were of international significance as similar disclosure policies were debated and revised in many countries.

“Transparency about payments from pharmaceutical companies to health care providers is increasing around the world and Australia should not fall behind,” she said.

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