Pharmaceutical companies offer payments to doctors and other healthcare professionals to promote their products. These payments are listed as consultancy fees and speaker fees and can also cover travel and accommodation expenses. Until recently, these payments were not fully disclosed, according to the Medical Journal of Australia (MJA), which published a research letter on May 6.
In 2016, Medicines Australia, the main industry association representing pharmaceutical companies in the country, updated its code of conduct to require members to disclose payments made to doctors and the amounts involved. (Related: RIGGED MEDICINE: Report finds nearly 60% of U.S. doctors received payments totaling over $12 billion from Big Pharma firms between 2013 and 2022.)
Since 2019, a centralized database on the Medicines Australia website has allowed people to search for information about individual doctors and the payments they received. The database includes payments for things, like registration fees, travel costs and fees for service (including grants and in-kind support), but not for food, beverages or research.
This information is updated every six months and remains accessible for three years.
The 2019-2022 cross-sectional analysis
The MJA conducted an analysis covering the period from November 2019 to October 2022. The data included details, such as the date of payment, the name and practice address of the healthcare professional, the nature of the service or event, and the payment amount. Each doctor's information was cross-referenced with their listing on the Australian Health Practitioner Regulation Agency (AHPRA) website.
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Additional details, such as specialty and gender, were also recorded. The number of practitioners in each medical specialty was sourced from the AHPRA 2020-2021 Annual Report. The study was granted an exemption from formal ethics approval by the University of Melbourne Human Research Ethics Committee.
The analysis revealed that more than 6,500 doctors – comprising almost five percent of all registered medical practitioners in Australia had received payments from pharmaceutical companies. Around 63 percent of the doctors – around 4,000 – were men.
These payments – totaling over AU$33 million, varied widely in size from AU$36 ($24) to almost AU$300,000 ($197,226).
Hematologists and oncologists received the highest payments at AU$6.13 million ($4.03 million), followed by cardiologists at AU$3.69 million ($2.43 million) and endocrinologists at AU$2.8 million ($1.84 million).
Conversely, rheumatology had the highest proportion of doctors receiving payments at almost 70 percent, while neurosurgery, emergency medicine and medical administration had the lowest proportions.
Among pharmaceutical companies, noted to have made the highest total payments were Novartis at nearly AU$3.69 million ($2.43 million), AstraZeneca at over AU$2.6 million ($1.71 million) and Bayer at more than AU$2.5 million ($1.64 million).
MJA investigation likely underestimating payments Big Pharma made to Australian doctors
The analysis acknowledged potential underestimation of pharmaceutical company payments since not all companies were represented by Medicines Australia. It also highlighted the exclusion of payments for food and beverages from reporting requirements–despite their prevalence at pharmaceutical industry events.
Findings from studies from the United States suggested that such payments can influence prescribing patterns and raise healthcare costs, particularly in the fields of hematology and oncology. Public awareness of these payments is limited and their disclosure could impact trust in the medical profession, according to the American Economic Association.
The MJA report recommended that Australian doctors reflect on their relationships with the pharmaceutical industry and consider whether accepting such payments aligns with public expectations. They advocated for greater transparency in reporting payments and suggested linking payments with AHPRA numbers to facilitate the identification of recipients.
Watch this video that talks about how much Big Pharma is paying doctors.
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