4.4 Article

Pharmaceutical industry self-regulation and non-transparency: country and company level analysis of payments to healthcare professionals in seven European countries

Journal

HEALTH POLICY
Volume 125, Issue 7, Pages 915-922

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.healthpol.2021.04.015

Keywords

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Funding

  1. Swedish Research Council for Health, Working Life and Welfare (FORTE) [2016-00875]
  2. Swedish Research Council (VR) [2020-01822]
  3. Swedish Research Council [2020-01822] Funding Source: Swedish Research Council
  4. Forte [2016-00875] Funding Source: Forte
  5. Formas [2016-00875] Funding Source: Formas

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This study conducted a comparative analysis of payment disclosures of 20 large pharmaceutical companies in seven European countries from 2017 to 2019, revealing significant differences in payment patterns between countries and companies. The research supports the implementation of a Europe-wide Sunshine Act to achieve real transparency in drug company payments.
The European pharmaceutical industry uses the alleged efficacy of self-regulation to question the need for transparency laws similar to the US Physician Payment Sunshine Act. We conducted a comparative analysis of 20 large companies' payment disclosures in seven European countries in 2017-2019. The data was extracted as part of eurosfordocs.eu, a novel transparency project that scrapes and integrates publicly available databases and disclosures. Our analysis of EUR 735 million showed marked differences in country payment patterns. For example, payment totals per registered doctor were substantially larger in Spain and lowest in Sweden. There were significant country and company differences in individualized data completeness. Only 19% of totals were reported with recipient names in Germany, compared to Ireland (59%), the United Kingdom (60%), Italy (67%), Switzerland (73%), Sweden (79%) and Spain (10 0%), with little or no improvement over time. Payment data in Spain was particularly difficult to extract. Thus, in no country did self-regulation generate comprehensive individualized data allowing for building an accurate picture of financial relationships between the industry and healthcare professionals. We conclude that the cultures and policies of countries and companies create structural problems of data inaccessibility and incompleteness within the self-regulatory framework. Therefore, this study supports calls for a Europe-wide Sunshine Act to achieve real transparency of drug company payments. (C) 2021 The Authors. Published by Elsevier B.V.

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