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Drug Money

No Drug Left Behind

The Greens health spokesman, Dr Richard di Natale, is looking to widen the reach of draft legislation intended to bring greater transparency to the largesse provided to health professionals by drug companies.

Senator di Natale flagged the changes after a hearing today into his proposed legislation by the Senate Finance and Public Administration committee.

Originally, the bill would have required the publication of the names of doctors in receipt of payments, gifts or other benefits from drug companies.

But, having received the submissions and heard evidence from several academic health experts, notably La Trobe University Professor of Public Health Dr Ken Harvey, Senator di Natale said the bill would be amended to ensure it covered all therapeutic goods suppliers, not just drug companies, and all health professionals, not just doctors.

“It was always intended to apply to all therapeutic goods,” he said, “but what was more ambiguous perhaps was the question of which health care professionals would be covered and how they would be defined.

“I think it’s reasonable to use the Australian Health Practitioners Registration Agency definition, and that includes doctors, pharmacists, nurses, physios, chiropractors et cetera – anyone who’s registered under the AHPRA scheme.

“And it would include all therapeutic goods, not just drugs but devices. Your artificial hips, your cardiac pacemakers, that sort of equipment.”

At the moment Medicines Australia, the peak body representing many of the drug companies, reports aggregate spending by drug companies in a limited range of areas, essentially “educational events” for medical professionals.

Under heavy government pressure, it is working on a new code, which would individually disclose at least some payments.

But some drug companies, such as those that produce mainly generic drugs, are not part of Medicines Australia and do not abide by even this limited code. There also are eight other industry associations, with varying codes of conduct, which reveal almost nothing about benefits provided to health professionals.

Senator di Natale’s bill would provide uniformity under law. But the therapeutic goods suppliers, drug companies and doctors insist a voluntary code will suffice.

Senator di Natale said he was encouraged that some of the drug companies – he instanced GlaxoSmithKline (GSK) – and the main doctors’ organisation, the Australian Medical Association (AMA), had shifted their position on individual disclosure.

<p>Mike Bowers/The Global Mail</p>

Mike Bowers/The Global Mail

“In the past the AMA has been absolutely opposed, on the basis that publishing the names of individual doctors could damage the reputation of the medical profession, but under [new AMA president] Dr Steve Hambleton, that has shifted,” he said.

Yet the AMA, like the drug companies, remained adamant that legislation was unnecessary.

“This is one of the themes that came through loud and clear, that Medicines Australia and GSK and all the industry groups were absolutely committed to self-regulation, even when it didn’t produce the outcomes that they said they thought were necessary,” the senator said.

“In the case of some of the big generic makers, the attitude is ‘Stuff you, we don’t want to be held to any code’. So we have Medicines Australia members saying they think self-regulation will work for them, but also saying they don’t think it’s working with the other bodies and their codes.”

Asked whether he would ever support an alternative proposal, such as Professor Harvey’s suggestion of industry codes, underpinned by government legislation enforcing membership of those codes, Senator di Natale said he remained open to further changes, and was committed to the outcome of transparency, not the means of ensuring it.

As to the likelihood of either of the major political parties falling in behind his proposal, he sounded dubious, particularly when it came to the Opposition committee members.

“Scott Ryan, the Coalition Senator who is deputy chair, is a former employee of GlaxoSmith Kline, so I’m not overly optimistic about him,” said Senator di Natale.

2 comments on this story
by Doug Flatimus

This story and its arguments, its apparent 'shock horror look what happens behind the scenes of your medicine cabinet' is pretty naive. This particular beat-up, like all the big pharma bashing pieces I've read in the last few years quite frankly ignores two very important factors that are never addressed by the journalists (is Ray Moynihan really a journalist?) who write them:

1. We (society) do not pay for the medical research required to meet the demands of the illnesses and diseases we suffer. Government does not support medical research to the extent required, and so the commercial world has filled the gap. That is a fact, ergo it is a business. Compared with other industries, it is a very ethical and professionally run business, nevertheless all businesses' primary motive is to generate/grow revenue and make a profit. Is this a conflict of interest? Not entirely, but there certainly are lines that should not be crossed.

2. Journalists generally do not approach this issue with a view to providing a balanced story. For example I've never seen a confidential relationship developed with any senior people in the industry in order to provide a balanced view, like "how many people are employed in the pharmaceutical industry?" and "Why do people work in the industry? What is the profile of senior marketing, medical, sales, regulatory, people in the industry compared with other industries, such as remuneration, education levels, etc.?"

Whenever a journalist decides to 'investigate' big pharma, it takes an approach that screams that the industry is no better than Big Tobacco or Big Banking: it's aim is to make money at the expense of its customers / patients and I intend exposing this terrible equation for my poor unknowing readers, who have no idea how corrupt their doctor is.

All of the big bashes on big pharma I've read in Australia carry this insinuation, and this is the reason most of these stories lack traction. People are not gullible - they see the advertising around the surgery, and they know doctors are influenced by the companies, but they also trust the doctor's professionalism, and they know that their taxes pay a regulatory authority that would not approve a product that was unsafe for their use.

The dichotomy apparently 'professional' journalists bring to this story is "Hey, this antibiotic has probably just saved my life ... (disconnect) ... Gee, big pharma make money from sick people! What's going on there?"

This approach clearly is fallacious, it is unreasonable, and it lacks integrity.

May 2, 2013 @ 8:21am
by Colin Hesse

Doug's comments are fine...up to point where one examines the profits of the pharmaceutical companies.

They are indeed in it for the money, and that's okay. The role of government is however to balance the public interest against the private desires, and as such it has a role in improving transparency and eliminating profit gouging.

Of course Government should increase public spending on improved and new drugs that will be owned by the public, but let us no pretend that the private companies don't benefit from public regulation.

May 6, 2013 @ 3:49pm
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