In June 2015, 24 Australian cancer specialists flew to Chicago to attend a five-day conference. Drug giant Amgen funded the trip, including registration, transfers and wining and dining. It cost almost A$270,000.
In December 2013, in a teaching hospital in New South Wales, 11 pharmacists and pharmacy technicians attended a 45-minute presentation by a pharmaceutical representative from a company called Menarini. The presentation was accompanied by a lunch that included sandwiches, wraps, sushi and fruit juice. Lunch cost A$200.
These are just two very different examples of the more than 116,000 events for Australian health professionals that drug companies funded in a recent four-year period, which we analysed in a study just published in BMJ Open.
You can examine the data yourself.
Since 2007, drug companies have been required to publish detailed reports of how they sponsor educational events for health professionals.
They have had to list the number of attendees, the name of the restaurant, resort or clinic, and the costs of food and drink. But so far, they have not had to list the names of the doctors enjoying it.
Until today there has been little analysis of these reports. This is because despite being publicly available, the millions of bits of data were “trapped” in PDF files. Now the information is available for anyone to analyse.
What did we find?
The data shows the routine, yet influential, ways health professionals interact with pharmaceutical companies when it comes to professional education.
Between 2011 and 2015, pharmaceutical companies sponsored more than 116,000 events – on average more than 600 a week. While many of the breakfasts, lunches and dinners were held in hotels and fancy restaurants across the country, most took place inside hospitals or doctors’ offices, suggesting drug companies have a pervasive presence in everyday clinical practice.
Most of the events (82%) included medical doctors, but many included different types of health professionals. For example, 39.6% included nurses, 38.3% trainees and 8.4% pharmacists.
Oncology or cancer – a field where there is increasing concern about the use of high-cost medicines – was the most frequent area of focus of the events, accounting for 19.7% of the functions.
Why does this matter?
Industry sponsored events for health professionals are commonly termed “educational” events. However, they are a key pillar of the pharmaceutical industry’s marketing strategy.
Although health professionals often fail to perceive commercial biases in such events, their educational content can be biased in favour of the sponsor. The prescription rate of the sponsor’s drug has also been shown to increase afterwards.
Even the provision of free meals, which are commonly provided at sponsored events, can influence clinical practice. Evidence of this comes from the United States, where thanks to the Sunshine Act, pharmaceutical companies have to report all payments to individual doctors.
Prescribing drugs based on exposure to industry-sponsored events raises concerns about the unhealthy effects on patient care and increasing health care costs when newer, expensive and aggressively promoted drugs are prescribed.
A recent study conducted in the US found the receipt of even a single sponsored meal worth as little as US$16 was associated with an increase in prescribing of promoted drugs.