UNLIKE HERE, DR REGINA FARRELL’S PATIENTS IN UPSTATE NEW YORK CAN SEE IF SHE’S BEEN PAID... WITH THE CLICK OF A MOUSE
PATIENTS at New York physician Regina A Farrell’s practice in Syracuse can be certain she is fully transparent when it comes to payments she may have received from drugs companies.
That’s because in America – unlike Ireland – there is nothing to hide and everything is above board and seen to be so. This transparency is ensured by the fact every US doctor can be searched by name in America’s Open Payment Database.
But this is not possible in Ireland, where more than 600 doctors who receive valuable benefits from pharmaceutical firms remain secret.
In the US, things are straightforward. In a couple of clicks, patients of Dr Farrell can see exactly what pharmaceutical firms spent on her.
In 2022, for example Abbvie Inc bought food and beverages for Dr Farrell on two occasions to a combined value of $31.55 (€29). Every cent
Abbvie spends on doctors in the US is transparent and public by default.
In the Open Payment Database, all such expenditure is listed clearly under headings such as food and beverage charitable contributions, guest speaker fees, education grants, entertainment, travel and lodging. Even debt forgiveness – to the doctor or their immediate family – is declared.
The Irish system is very different. Here, it is not mandatory to declare benefits received from drugs firms.
The number of medical professionals who do consent to being named is rising and now stands at 79% – but hundreds of doctors who receive close to a €1m between them still remain anonymous.
According to the voluntary database run by the Irish Pharmaceutical Healthcare Association
(IPHA), Abbvie made transfers of value to 93 doctors in Ireland, whose identity remains secret. They shared €186,543 – an average of €2,005 each. That figure is significantly more than a coffee and a snack. In fact it’s more akin to the amount many firms spend bringing doctors to conferences in foreign climes. There are dozens of
named Irish-based doctors in the latest IPHA declaration who have declared that they received ‘travel and accommodation’ from drugs firms of about this amount. But doctors can still choose to keep this secret and hundreds do.
Instead of transparency, what Ireland has, in the words of a Royal College of Surgeons in Ireland study, is a system that is ‘completely obfuscated’. In the Irish declarations, research payments are shown in aggregated form, with no entities or individuals named.
The RCSI study states: ‘Only a total value for research payments made to doctors and health facilities is disclosed per company, with no details of the number of payments or recipients. Though such funding may be disclosed if research reaches publication, this would be long after the payment and publications rarely disclose the amount of funding.’
Even the data presented on those doctors and healthcare organisations, identified as the beneficiaries of payments in the Irish system, can be impossible to decipher. So say RCSI experts who reviewed the system in 2021 and whose study, published in the Health Policy journal, showed a system of self-regulation is hardly transparent. The study stated: ‘An opt-out clause, along with provision of user-unfriendly data appear to be the norm when industry self-regulates.’ Only the last three years’ of data from Ireland’s voluntary system is up on transferofvalue.ie – the IPHA’s transparency database, and so those who want a better picture must scrape the site’s data before it disappears and save it to compare to future years.
The Irish Mail on Sunday has done this since the site went live in 2016. So did the RSCI team.
But for that, this data, everything before 2020, would now be gone. Because we saved this data, we can show that since the system was launched in 2016 Abbvie has spent €1,463,529 on payments to doctors that remain completely secret.
Last night an Abbvie spokesman told the MoS it supports disclosure of all partnerships and ‘advocates for transparency on all transfers of value to healthcare professionals.’
Another userunfriendly aspect of the Irish site is that the data is inaccessible to search engines. It is contained in
50 or so individual reports by company name for each of the three years available. Each report for each company, for each year, must be viewed separately from the rest. There is no way of easily cross-checking which doctors or organisations got payments from different firms.
In their study, the RCSI academics documented ‘various data errors, and significant variation between companies in their methodology, notes and disclosures, with inconsistent approaches to identifying individuals, and aggregation and exclusion of payments’. They also found breaches of the industry’s own voluntary code. In one case, a firm excluded all payments under €100 from disclosure.
This error was corrected, but the identity of the company kept secret. By contrast, in the US that same firm would have to report spending on every last latte.