INVESTIGATION: BIG PHARMA PAYING MILLIONS TO SCOTS DOCTORS
DOCTORS, nurses and health bodies in Scotland have benefited from £4.5 million from phar maceutical companies in the last year, a Sunday Herald investigation has established.
A new database reveals doctors and professors north of the Border received at least £1.5m from socalled “Big Pharma” for items including consultancy fees, speaker slots and travel, and accommodation for events. Forty-six payments of £5,000 or over were declared, while one professor benefited from over £96,000 of support.
However, the sums are only a fraction of the total amount paid out, as disclosure is on a voluntary basis. Links between pharma companies and doctors are controversial as drug firms soak up a huge chunk of the NHS budget in Scotland. Critics believe it is unhealthy for healthcare professionals involved in assessing which drugs are given to patients to have financial relationships with firms. But doctors strenuously deny any suggestion that taking money influences prescribing practices.
Industry bodies believe partnerships between medics and companies benefit patients.
As part of a Europe-wide initiative to boost transparency, the Association of the British Pharmaceutical Industry (ABPI) recently published a list of payments and benefits in kind from companies to doctors, nurses, pharmacists and health bodies.
However, the Disclosure UK system, which covers 2015, has a major loophole: companies provide the data to the ABPI, but the individuals who have benefited are not named unless they agree. An analysis published in the British Medical Journal found that only 70 per cent of healthcare professionals in receipt of payments agreed to be named – although the dataset provides the fullest picture yet of the links between industry and staff.
According to the ABPI guidance, drug company disclosures fall into various categories.
A common payment is for “service and consultancy”, which can include speaking at and chairing meetings, writing reports or participating in pharma advisory boards. Firms can also sponsor a doctor’s attendance at meetings, some of which are overseas, and pick up the bill for travel, accommodation and registration fees. Another category is “joint working”, which usually consists of the NHS and companies pooling their resources to work on projects.
A Sunday Herald analysis of the ABPI database has produced a comprehensive account of Scotland-related payments. This newspaper has identified 3,341 transactions – totalling £4.5m – by dozens of pharma companies. The average “transfer of value” (TOV) – the term used by the ABPI to describe payments and benefits in kind – came to about £1,348 and some individuals received more than one fee.
Hospitals, medical schools, clinics and health forums also showed up in the payments. The dataset revealed 1,490 entries for “doctors” and “professors” in Scotland, with these payments totalling £1.5m. However, it is likely the 1,490 figure will be an underestimation as there may be doctors classed as “Mr”, “Mrs” and “Ms” in the dataset who are not part of this newspaper’s analysis.
PROFESSOR Brian Lipworth, a specialist in allergy and respiratory medicine at Dundee University, received nearly £96,000 from Teva UK Ltd. The sum comprised two elements: £83,000 for the work involved in delivering educational talks to doctors in the US on a Teva product; and £13,000 that covered the travel, accommodation and subsistence expenses relating to the trip. Lipworth said: “I think it’s important for all clinicians to declare earnings from pharma in the same way that they are mandated to do in the USA.”
The database showed that Dr James Overell, a consultant neurologist in Glasgow, benefited from £19,350 from multiple sclerosis drug company Biogen Idec Ltd.
Overell said: “The payments were made for a number of different speaking engagements at educational and training meetings both in the UK and abroad, chairperson duties at educational and training meetings, and for participation in advisory boards.”
According to the dataset, Professor David Goldberg, a consultant in public health medicine, received £9,600 in fees from Bristol-Myers Squibb Pharmaceuticals Ltd. The payment was for a report he produced in relation to alcohol and hepatitis C and was not related to the company’s products. Dr Gregory Jones, a consultant in diabetes and endocrinology in the west of Scotland, is registered as benefiting from £12,900 worth of support from pharma giant AstraZeneca.
A spokesperson for NHS Greater Glasgow and Clyde ( NHS GGC) said: “The figure noted for Dr Jones is an accumulated figure over a year relating to speaking engagements at national and international events as well as participation on advisory boards. He requested his details were published in the database in the interests of full transparency.”
Professor Barrie Fisher, another consultant in Glasgow, received £9,553 from Sanofi Aventis in “related expenses agreed in the fee for services or consultancy contract”.
A spokesperson for NHS GGC said: “The figure noted for Professor Fisher is an accumulated figure relating to lecturing engagements and participation on advisory boards. All engagements were carried out in Professor Fisher’s own time and not on NHS sites.”
Pharma company Genzyme declared £3,852 in “travel and accommodation” for Dr Alison Cozens, which a spokesperson for NHS Lothian said covered the costs for her to attend a medical conference.
There is no suggestion of impropriety by any of these health figures, who, unlike some of their colleagues, consented to the data being published.
A spokesperson for BMA Scotland said: “Generally, this type of funding is to enable healthcare professionals to attend or speak at conferences where new clinical innovations are presented that can transform the way medicine is practised, bringing real improvements to the care of patients.
“It is essential that drug company funding of such events is completely transparent and that they meet the standards set out in the ABPI code of practice and the standards of professional conduct for doctors set out by the General Medical Council.
“There must be no conflict of interest and drug companies should not attempt to influence the prescribing practices of doctors or exert undue influence over the health service.”
According to the data, 402 payments and benefits in kind worth £172,953 were made to individuals in the “nurse” category from drug firms.
RCN Scotland, which represents nurses, declined to comment. A smaller amount was received by pharmacists, whose 74 payments came to around £31,650. The figures also reveal the biggest industry payers in Scotland. AstraZeneca, a British-Swedish multinational, doled out 254 TOVs totalling nearly £325,000. GlaxoSmithKline is listed as making £255,000 worth of TOVs. Swiss giant Novartis registered 203 payments that were worth around £353,000. Pfizer made nearly £374,000 of TOVs.
There must be no conflict of interest and drug companies should not attempt to influence the prescribing practices of doctors