- Find a Healthcare Agency
- Case Studies
- Online tools
- About Nat
Should Canadian doctors disclose how much Pharma pays them?
Canadian pharmaceutical professionals who work for Rx&D member organizations follow the Code of Ethical Practices, which, among other guidance, provides guidelines on when and how the organization can provide financial or other type of incentive to physicians. These guidelines help maintain trust in the pharmaceutial industry by consumers and all other healthcare stakeholders, and also provide some consistency in how healthcare professionals (HCP) are treated from one organization to the other.
But how would you feel if all financial and other types of gifts that you provide to physicians for their services were made public for the whole world to see? That’s exactly what will be happening in the U.S. in January 2012 (only 9 months away). This is a result of the “Sunshine Provisions” Act, which was passed in March 2010.
Paul Meade of Thought Leader Select (disclaimer: Thought Leader Select is my blog sponsor) has written an article questioning the benefits of the transparency that will be offered by the Sunshine Provisions Act: ” Transparency and the Sunshine Provision – Is This a Good or Bad Thing?
Canadian Pharmaceutical Advertisement Advisory Board (PAAB) Commissioner, Ray Chepesiuk, kicks off the discussion with the following comments:
Paul Meade asks “So why are we so concerned with knowing what healthcare professionals get paid for advising healthcare manufacturers?” He goes on to answer his question “Maybe we just want to know that a medical expert is receiving fair compensation for his consultative services in a way that would not bias their judgment. But the transparency that is most important to me when receiving medical care from one of these experts is more about disclosure and conflict of interest, than it is about how much compensation that expert makes for advising manufacturers.” That may be a small part of the concern. The large part of the concern from a public health and societal good point of view is “what influence do these key opinion leaders have on the broader population of physicians and the provision of health care services?” This effect may be more profound on public health and on the payers.
Looking at this issue from a broader perspective can help one see why there is a perception that excessive payments from pharma to health professionals may not be a good thing. See the effect of actual cases at Emory and Harvard Universities. The final paragraph states “Disclosure serves a valuable purpose, especially for investigative reporters and attorneys. But the real problem of pharmaceutical industry gifts and payment to doctors is not secrecy, but influence. Doctors who take money or gifts from a pharmaceutical company are more likely to prescribe that company’s drugs, write favorable journal articles about the drugs, give lectures recommending the drugs and suggest adding the drugs to a hospital formulary. That influence does not disappear when the payments are disclosed. To fix that problem, the payments must be eliminated.”
For those who are less familiar with the Canadian Rx&D Ethics guidelines, here are a few excerpts that highlight how Canadian pharma can and cannot compensate healthcare professionals. For the full code of ethical guidelines, go here.
- 6.1.3 Members must never provide a donation, directly or indirectly, in order to have access to a health care professional.
- 6.2 Access Fees: Under no circumstances shall a Member company pay a “clinic room rental fee”, “clean-up fee” or any other similar type “fee” that can reasonably be construed as a direct or indirect payment in order to gain access to a HCP.
- Advisory boards: 13.3 Remuneration must be in the form of an honorarium (fair and reasonable). Travel, accommodation and out-of-pocket expenses in providing the consulting service, where warranted, may be reimbursed.
- CHE: 4A.3.4 Member companies should not be involved in the development of, or payment for social functions conducted in conjunction with any CHE event.
- 4A.3.5 Grants and honoraria may be provided to health care professionals who speak at or moderate CHE programs. Such grants and/or honoraria do not apply to other health careprofessionals attending the program. Members may provide financial support for a maximum of ten (10) individuals to any one international CHE event. Notwithstanding the provisions in Section 7B.1.3. a member company may extend hospitality to all their duly sponsored health care professionals to international CHE event. For hospitality, please refer to sections 7B.1.4 and section 7B.1.5.