Pharmaceutical companies pay doctors more than A$11 million a year for travel and education. Here are the specialties that received the most

Our research shows that pharmaceutical companies pay Australian doctors millions of dollars a year to fly to overseas conferences and meetings, lecture to other doctors and sit on advisory boards.

Our team analyzed reports from major pharmaceutical companies, in the first comprehensive analysis of its kind. We found that pharmaceutical companies paid doctors more than A$33 million in the three years from the end of 2019 to the end of 2022 for these consultations and expenses.

We know that this is an underestimate of the amount that pharmaceutical companies pay doctors because it ignores the most common gift – food and drink – that pharmaceutical companies in Australia do not disclose.

Due to COVID-19 restrictions, the timescale we analyzed included periods when physicians are likely to be traveling less and attending fewer live medical conferences, so we suspect that the current level of funding for pharmaceutical companies is even higher, especially for travel.

What we did and what we discovered

Since 2019, Medicines Australia, the trade association for the pharmaceutical industry producing branded medicines, has published a centralised Database payments made to individual health care workers. This is the first comprehensive analysis of this database.

We downloaded the data and compared the doctors’ names with the lists in the Australian Medical Practice Regulatory Agency (Ahpra). We then looked at how many doctors per medical specialty received payments from industry and how much companies paid each specialty.

We found that more than two-thirds of rheumatologists received payments from industry. Rheumatologists often prescribe costly fresh biologic drugs that suppress the immune system. These drugs are responsible for a significant part the cost of medicines under the Pharmaceutical Benefits Scheme (PBS).

The specialists who received the most funding as a group were medical oncologists (oncology/hematology specialists), receiving more than $6 million in payments.

This is not surprising, given the recent approval of costly fresh cancer drugs. Some of these drugs are great advances in treatment; others offer minimal improvement in survival or quality of life.

AND Study 2023 industry-paid physicians were found to be more likely to prescribe anticancer drugs with low clinical value.

Our review found that some physicians received multiple diminutive payments of several hundred dollars. There were also cases of enormous individual payments.

Why is all this so critical?

Doctors I usually believe promotion by a pharmaceutical company has no effect on them. But research says otherwise. Industrial payments may affect both the prescribing decisions of doctors themselves and their colleagues.

AND study in the USA Studies of meals provided to physicians — which cost less than $20 on average — found that the more meals a physician received, the more of the advertised drug he or she prescribed.

Another study found that the more meals a doctor received from manufacturers of opioids (a group of mighty painkillers), the more opioids they prescribed. Over-prescribing played a key role in the opioid crisis in North America.

Overall, a significant amount of research has been conducted to introduce Industry financing influences drug prescribing, including for drugs that are not first choice due to destitute efficacy, safety or cost-effectiveness.

There are also doctors who act as “key opinion leaders” for companies. These include paid consultants who give talks to other doctors. A former industry employee who recruited doctors for such roles he said:

Key opinion leaders were salespeople for us, and we regularly measured ROI by tracking prescriptions before and after their presentations […] If a particular speaker didn’t make the impression the company expected, you wouldn’t invite him or her again.

We know about payments to doctors in the US

The best available evidence on the impact of pharmaceutical industry funding on prescribing comes from a U.S. government program called Open payments.

Since 2013, all drug and device companies have been required to report all payments of more than $10 in any given year. Payment reports are linked to promoted products, allowing researchers to compare physicians’ payments with their prescribing patterns.

The analysis of this data, which involved hundreds of thousands of doctors, It has been undoubtedly shown Promotional fees influence prescribing.

Research in the USA It also shows that doctors who trained at medical schools that banned students from accepting payments or gifts from pharmaceutical companies were less likely to prescribe newer and more costly drugs, with narrow evidence of their greater effectiveness compared with existing drugs.

Generally speaking, Australian medical faculties have weak or no restrictions on medical students meeting with pharmaceutical sales representatives, receiving gifts, or attending industry-sponsored events during their clinical training. Nor are there any restrictions on faculty members consulting with manufacturers whose products they present in their teaching.

The first step in preventing the pharmaceutical industry from unduly influencing prescribing decisions is to protect medical students from that influence by implementing stronger conflict of interest rules, such as those mentioned above.

The second is better advice to individual doctors from professional bodies and regulators about what types of funding are and are not acceptable. We believe that no doctor actively involved in patient care should accept payments from a pharmaceutical company for calls, international travel, or consultations.

Third, if Medicines Australia is stern about transparency, it should require companies to list all payments – including food and drink payments – and link healthcare workers’ names to their Ahpra registration numbers. This is similar to the reporting standard used by pharmaceutical companies in the US and would provide a fuller and clearer picture of what is happening in Australia.

Patients trust their doctors to select the best available treatments to meet their health needs, based on scientific evidence of safety and effectiveness. They do not expect marketing to influence that choice.