Endocrinologists’ $10k fees from industry raise concerns over conflict of interest

Undisclosed pharmaceutical industry ties are common among endocrinologist ‘key opinion leaders’ who hold leadership positions in diabetes organisations, an Australian study has found.

Industry fees averaging $10,702 (range $2638–$28,744) were made to 24 of 33 endocrinologists who held positions with professional medical groups between 205 and 2018, according to an analysis by Sydney University researchers.

However only one association disclosed payments on its website and of the nine endocrinologists with this group who were received payments, four provided conflict of interest statements; all of which were incomplete.

Overall, 73% of medical leaders within diabetes organisations received pharmaceutical  industry payments, predominantly for supported speakers (51.4%) and advisory board (25.3%) engagements.

The reported payments to endocrinologists, obtained from data held by Medicines Australia, were likely to be an underestimate because they covered only pharma companies and not other medical device companies, the researchers said. They also noted that endocrinologist payments were more than double the value of those given to doctors in general medical groups, which averaged $5485. Cardiology opinion leaders received an average of $9892 in industry payments over the same period.

“The difference between GPs and other specialists may reflect the relative return for investment for pharmaceutical companies in increasing sales,” the researchers said.

“Payments to endocrinologists and cardiologists have been associated with greater increases in prescribing of marketed diabetes and cardiovascular medicines than payments to other specialties,” they wrote in the Australian Journal of General Practice.

Leaders of diabetes groups accounted for $537,910 of the $932,270 payments to members of 10 professional medical associations analysed over the three year period. The three highest-paying companies were AstraZeneca ($175,342), Novo Nordisk ($165,774) and Sanofi ($140,174).

The findings raise concerns about industry influence on clinical practice and policy, said the authors led by Professor Lisa Bero (PhD) and Dr Emily Karanges (PhD) of the Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney.

“Medical organisations and their leadership have a responsibility to ensure conflicts of interests are disclosed, minimised and managed responsibly,” they wrote.

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