Neurologists receive highest amount of pharma industry payments

By Megan Howe

12 Aug 2020

Neurologists receive the highest median payments from the pharmaceutical industry of any speciality, a new study shows.

Researchers analysed payments from the pharmaceutical industry to doctors in different specialities between November 2018 and April 2019, based on data provided to the Disclosure Australia website, as required under the Medicines Australia Code of Conduct.

They found that over the six month period neurologists received median payments of $2415, followed by $2131 for medical oncologists, which compared to a median of $1376 for all internal medicine specialists and $709 received by non-specialist medical practitioners including GPs.

In all, 88 of 677 neurologists (13%) received total payments of $321,247, with individual  payments that ranged from $184 to $14,645, most commonly for travel costs and service fees such as consulting and advisory panel payments.

However other specialties had higher proportions of doctors receiving industry payments. The study in the Internal Medicine Journal estimated that 31.7% of all Australian medical oncologists and 30.9% of clinical haematologists received payments during the period studied, period, a rate three times higher than the 11.7% average for specialist physicians.

The authors of the study say the findings are a reflection of the influence of industry in funding development of expensive novel therapies – especially cancer drugs – rather than the behaviour of doctors in accepting payments.

Medical oncologists received the highest total amounts payments of any of the specialist groups studied – $1.03 million, followed by endocrinologists ($758,648), cardiologists ($722,663) and haematologists ($719,565).

The study authors acknowledged that some interactions between physicians and the pharmaceutical industry were “unavoidable”, but cautioned that “any interaction creates a conflict of interest”.

“It is in the interest of patients to have access to major clinical trials, and these are frequently designed and sponsored by drug companies. Novel medications are often accessed by patients directly from drug companies ahead of federal funding, with cancer physicians acting as the prescribing intermediary,” they noted.

Lead author Dr Adrian Pokorny, a medical oncologist at Royal Darwin Hospital, told the limbic that the study highlighted the extent of pharmaceutical company influence, rather than criticising the behaviour of doctors who received payments.

“I have a lot of respect for all oncologists and don’t think ill of any of my colleagues,” he said.

While it was impossible for specialists to avoid interaction with pharmaceutical companies, Dr Pokorny said receiving payments meant there was potential for bias in prescribing.

Oncologists in the US were more likely to prescribe some anti-cancer drugs over their competitors, such as sunitinib, dasatinib and nilotinib, if they have received payments from the drug’s manufacturer, despite no clear evidence of direct clinical superiority, the study authors said.

Dr Pokorny said his personal policy was never to meet pharmaceutical company representatives, so he had not been offered any payments.

The COVID-19 era of telemedicine and online conferences had offered an alternative way for doctors to be involved in international conferences without any need for travel, he suggested.

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