Australia heads towards disclosure of doctor payments from pharma

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In October, pharmaceutical companies in Australia will follow the lead of their counterparts in the US and start reporting payments to doctors under a new code of practice.

The trade group that represents pharma companies in the country – Medicines Australia – implemented the new code of conduct after the creation of a database was mandated by the Australian Competition and Consumer Commission (ACCC) in April.

The new policy requires reporting of payments by pharmaceutical companies to healthcare professionals for services or education, and comes after months of negotiation between Medicines Australia and the ACCC and other stakeholders such as the Therapeutics Goods Administration (TGA), the national regulator.

The code has been criticised by some however for excluding payments of A$120 or less – per meal - for food and beverages, as well as including a clause which says payments need only be disclosed "where they have the agreement of the healthcare professionals who are receiving them" in the first 12 months of the scheme.

That contrasts with the situation in the US, where under the recently introduced 'Sunshine Act' any payment over $10 is reportable, and doctors had no right to block disclosure. Just-released figures from the US Centers for Medicare & Medicaid Services (CMS) reveal that pharma companies paid $6.49 billion to doctors and teaching hospitals last year.

From 1 October 2016, however, the code will require reporting of all these payments to healthcare professionals to be mandatory, closing a loophole proposed in earlier drafts. Companies will report the payments made during a six-month period on their websites, within four months of the end of each reporting period – i.e. by the end of August and the end of February each year.

There will be no centralised database as in the US, although Medicines Australia says this may be established in future.

The Consumers Health Forum of Australia is among organisations that feel the $120 threshold undermines the system by making it possible for doctors to be regularly 'wined and dined' by drugmakers and does not take into account the possible impact of even small inducements on prescribing practices.

The ACCC did not agree however, and said that making these expenses reportable would impose a "significant administrative burden" on pharma companies.

The debate over the payment reporting comes as Australia's drug industry is already under pressure, coming under fire in the Senate earlier this month when big-name pharma companies – including Pfizer, AstraZeneca (AZ) and GlaxoSmithKline (GSK) – were accused of operating complex cost-structures that ramp up the cost of medicines to Australian consumers and sidestep national taxes, reports the Sydney Morning Herald.

From 2016, drugmakers in Europe will also have to disclose payments and "transfers of value" to European doctors and healthcare institutions as well as those in the US under a new code of practice drawn up by the European Federation of Pharmaceutical Industries and Associations (EFPIA).

Some pharma bodies in Europe – including members of the Association of the British Pharmaceutical Industry (ABPI) – are already adhering to that code.

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Andrew McConaghie

13 July, 2015