While collaborations between the medicines industry and health professionals are desirable, widespread financial ties bring significant risks of undue influence on professional judgements, potentially jeopardizing the integrity of medical research, education, clinical practice and public trust in medicine, according to a landmark 2009 report from the National Academies of Science in the United States.
The Australian medical industry is no exception, but current regulation does not provide the required transparency about financial ties between drug companies and medical professionals.
Consumers Health Forum and academic Dr Ken Harvey are advocating for changes to the Medicines Australia Code of Conduct which is up for review and authorisation by the ACCC.
Dr Harvey points out that if the 17th Edition of Medicines Australia Code is authorised for another 3 years in accordance with the ACCC’s draft determination, then Australia will fall behind the level of transparency that will come into force in the U.S. next year as a consequence of the Physicians Sunshine Payment Act. He believes this is unacceptable and has petitioned the ACCC to make the following changes to its draft determination.
- Reduce the period of authorization of the Code of Conduct to one year (2013).
- Request Medicines Australia to submit a revised Code to include arrangements covering transparency of relationships between the pharmaceutical industry and individual health professionals for authorization at the end of 2013.
- Request Medicines Australia to increase the number of informed critics of their current Code regarding transparency matters on the transparency working group.
Dr Harvey also calls on the Commonwealth government to consider introducing legislation similar to the Sunshine Act, to bring Australia into line with international benchmarks on transparency in healthcare. In support of his calls for action by the ACCC and the Commonwealth he has launched an online petition. The petition has recieved over 360 signatures and is available at http://tinyurl.com/d746xa5.
The Consumer’s Health Forum has been asked to present a submission to the ACCC. The CHF has applauded the elements of the code that have been strengthened, such as increased transparency of company sponsorship of health consumer organisations, including through publication of reports of support for health consumer organisations on the Medicines Australia website. Additionally CHF welcomed better disclousre around Patient Support Programs, following revelations last year about pharmacists receiving payments to enrol consumers in these programs without disclosure of these payments to the affected consumers.
CHF has suggested further changes to improve transparency:
- require individual level, rather than aggregate level, reporting of payments and sponsorships to health professionals
- give consideration to whether the financial penalties associated with breaches of the Code are sufficient to protect Australian health consumers from unethical promotional activities, and urge an increase in penalties consistent with international requirements
- consider how the handling of complaints against non-members of industry associations can be more effectively addressed
The CHF has also raised other concerns with the draft Code beyond issues of transparency.
The ACCC is expected to make a final determination on these matters in a few weeks’ time.
Dr Harvey’s petition includes the following conclusion “if no changes are made to the draft determination, aggrieved petitioners will ask for a review of this determination by the Australian Competition Tribunal on the grounds that the limited public benefits do not in our view (and on expert advice) outweigh the anti-competitive detriments of the deal.”