One-fifth of pharmaceutical industry payments are made to non-prescribing healthcare professionals such as nurses and pharmacists, a new review reveals.
According to the authors from the University of Sydney’s Evidence, Policy and Influence Collaborative at the Charles Perkins Centre, the findings raise questions around influence and identify a need for greater transparency.
“In contrast to the high scrutiny and regulation of physician-industry relationships, interactions with non physicians remain relatively hidden and unregulated,” they wrote in the letter published in JAMA Internal Medicine.
“In light of the expanding roles of non physicians in chronic disease and medication, our findings suggest there is an urgent need to extend mandatory transparency reporting and institutional policies to all healthcare professionals”.
Looking at data from Medicines Australia the authors found that between October 2015 and April 2018, 14,018 healthcare professionals received $62,695,095 in pharmaceutical industry payments.
While most payments were to doctors, other healthcare professionals accounted for 22.1% of recipients and 16.1 % of payments which equated to 10% of total spend.
Nurses and pharmacists were the primary recipients after doctors: nurses accounted for 17.8% of recipients but received 8.3% of expenditure, and pharmacists accounted for 2.9% of recipients and received 1% of total spend.
“There is a mistaken idea that non-prescribing healthcare professionals don’t have much influence on medicine use, therefore their pharmaceutical industry ties aren’t that important,” said lead author Dr Emily Karanges.
“Yet healthcare professionals like nurses and pharmacists often assist with medication choice and encourage adherence to treatment – and the roles they play in chronic disease management are expanding too.”
Payments were reported to support attendance at meetings and speaker and advisory board engagements, as well as associated travel and accommodation costs.
Co-author Professor Lisa Bero from the Charles Perkins Centre and School of Pharmacy said the findings were unique and had global implications.
“Pharmaceutical companies are clearly courting non-prescribing healthcare professionals as well as doctors in Australia, presumably because of the increasingly important role and influence they have in clinical care.
“Inevitably this type of activity and potential influence is happening around the world, but pharmaceutical influence on non-prescribers remains hidden because the data are simply not available in other countries.
“There is an urgent and global need to extend mandatory transparency reporting and institutional policies that apply to all healthcare professionals.”