Medicopolitical

Rheumatology professional societies criticised for financial entanglements with industry


Extensive financial links between the leaders of US rheumatology professional associations and the pharmaceutical and medical device industries have raised concerns over independence and integrity.

More than A$26 million (US$17.7m) in industry payments flowed to leaders of the American College of Rheumatology over a five year period according to figures published in BMJ.

Rheumatologists were third after the American Society of Clinical Oncology ($84m) and the American College of Cardiology ($35m) in the amount of industry financial support, according to the analysis of publicly available Open Payments transparency databases conducted by researchers from Bond University, Queensland.

The vast majority of the industry funding ($24.4m) to the ACR leaders was payments for research, with only $1.9m in general industry payments for fees for consultancy, speaking, royalties and hospitality.

The analysis showed that almost all leaders of the ACR (88% of the 33 clinicians) had financial ties to industry, with median payments to individuals of $374,000 and payments ranging from $4800 to $1.42m.

Other professional associations whose leaders had high levels of financial payments from industry included the the North American Spine Society ($16m) and the Endocrine Society ($10.5m).

The study’s lead researcher, Dr Ray Moynihan from Bond University’s Institute for Evidence-Based Healthcare, said the financial links raised serious concerns about the independence of medical associations and societies influential in areas of research, education, and practice, including guideline development.

“I was surprised by the extent of the money flowing to these medical leaders, overall US$130 million to around 300 leaders over a roughly five-year period, it’s an enormous amount of money and an enormous amount of influence.

“For the areas where we did find big flows of money, this is very worrying … As we know from the evidence, extensive ties between industry and doctors can undermine the integrity of scientific research, medical education and clinical practice – including the drugs doctors prescribe. There’s a real need for much more independence among this medical leadership.”

Dr Moynihan said there was a growing view that the leaders of medical associations should be free of financial relationships with the wider medical industry.

“These powerful doctors’ groups have enormous influence in the US and globally, including over the definitions of disease, which determine who’s healthy and who’s sick. It’s basic common sense that these leaders should be free from financial ties to companies which stand to gain enormously from the work of these medical associations.”

Dr Moynihan noted that research also showed Australia had fallen way behind in the transparency stakes, underlining the need for a US-style Open Payments system in Australia.

“We could not do this study in Australia in the same way, we do not have the mandated government-run open payments system that would allow us to investigate these sorts of ties,” he said.

“We do have a system in Australia, but it’s a self-regulatory system run by the pharmaceutical industry itself, it’s nowhere near as comprehensive and it’s certainly not grounded in legislation the way the American system is.”

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