As the majority of medical doctors support the issue of public disclosure of benefits resulting from their cooperation with pharmaceutical companies, why haven’t they undertaken any actions in this area so far?

The European Federation of Pharmaceutical Industries and Associations (EFPIA) is working on a common model of disclosing the register of benefits derived by medical doctors and other medical staff from the cooperation with pharmaceutical companies that would be uniform in all countries. The model is planned to be launched in 2016, also in Poland. It will be required to disclose remuneration for clinical tests, advisory services provided in the process of test planning, consultations as well as gifts or funded participation in conferences held abroad.

An Interview with Richard Bergström, Director of the European Federation of Pharmaceutical Industries and Associations (EFPIA)

JUDYTA WATOŁA: Why do pharmaceutical companies opt for the transparency policy?

RICHARD BERGSTRÖM: Everybody knows that we manufacture medicinal products, but they do not know how we do it. People think that our employees in white lab coats just work in laboratories and manufacture pills. And they wonder why – as it seems so simple – some of the pills cost as much as 100 euro. The reality is different because in order to manufacture such a pill, it takes years of tests we have to fund. Also, the risk that the therapy fails is on our party. It costs. We want to show it to the public.

What for?

To build trust. Tests of new medicinal products are not possible without patients. The patients have to trust us in order to agree to participate in them. Then, we have to discuss the results and teach medical doctors how to apply the new therapies. That is why companies pay doctors for the work on tests and for their participation in conferences.

There is another reason. In Poland, we can often watch on TV doctors who try to persuade us that some particular medicinal product should be refunded. The purpose is to avoid suspicions that the doctors advise so because they cooperate with a company X, the manufacturer of this particular product.

That is true. Medical associations have already realised the fact and, therefore, if somebody recommends certain medicinal product, usually they have to reveal the source confirming that the specific product is so good. The cooperation between experts and pharmaceutical companies as such is nothing wrong. On the contrary, if somebody has never cooperated with any company, they are not reliable because, in such a case, on what grounds they could evaluate the test results for new medicinal products. Furthermore, if they cooperated only with one company, we may suspect that they are not objective in their opinions.

Vast majority of medical doctors supports the transparency policy.

We can ask a question: if this is so, why they have not done anything here so far? It would be best if they made the register of benefits public themselves. We want to publish the data online, but it would be best if patients could ask the questions directly to the doctors or nurses.

Does the support for transparency vary across countries?

In Great Britain or Scandinavian countries, the support is higher because in these countries the transparency culture has been cultivated for a long time and medical doctors assert themselves as a sort of public service officials. In Germany, the situation is different; medical doctors feel they are highly independent and high in the hierarchy. Lower support for transparency is found in some countries of southern Europe, for example in Greece. However, we have to remember that those are only declarations. When we eventually make the registers of benefits public, there will be more opponents. That is why before the disclosure, we have to convince the public that the cooperation between pharmaceutical companies and medicinal doctors is necessary.

In the USA, the disclosure of benefits is sanctioned by law. The principles of transparency adopted by the European Federation of Pharmaceutical Industries and Associations shall not be the governing law. Medical doctors may tend to disrespect them.

We are not in the position to force medical doctors to reveal their data, but we can take on the responsibility. At this moment, many companies include non-disclosure clauses with respect to the benefits provided by contracts completed with medical doctors. If a doctor does not want to respect it, they simply should not sign the contract. Of course, we would rather not impose anything onto doctors. In time, they will get used to it. Some time ago many companies used to sponsor attractive trips for doctors and their entire families. When the fact was widely discussed in public, the practices were abandoned. I suppose that during those three years, until the registers of benefits from companies have been disclosed, major “cleaning” shall take place.