Learning the lessons of aggregate disclosure: the UK perspective (Guest blog)

Dis.clo.sure [ dih-skloh-zher] – noun the act or an instance of disclosing; exposure; revelation

In 2013, the UK pharmaceutical industry first took the step of disclosing the total sum of the payments it had made to healthcare professionals (HCPs) during 2012. Never before done, this was considered, by industry, as a bold move heralding a new era of openness about the existence of these important industry/HCP relationships, which bring life-enhancing and life-saving medicines to patients.

However, despite industry anticipation of wide interest in the fact that UK health professionals received £40 million from the pharmaceutical industry, the news received little more than a lukewarm reception. Subsequent annual announcements of total payments to healthcare professionals in 2013 and 2014 (£38.5 million and £40.98 million respectively), were greeted with an equivalent lack of excitement. How could it be that the disclosure of these payments was not met with the same level of enthusiasm outside of the industry?

Why? Because openness around the unique relationships between industry and healthcare professionals is already considered a ‘hygiene factor’. Why wouldn’t industry and HCPs want to be transparent about how they work together?

Unlike perhaps other industries and professions, these relationships bring together the public and private, the theory and practice which together make a difference to the lives of people worldwide. The outcome of these relationships has led to the eradication of some diseases (in the case of the discovery of vaccines for example), seen diseases like HIV/AIDS and cancer change from almost certainly terminal to manageable, and enabled people to live long and happy lives, whilst managing long-term conditions such as diabetes and heart disease.

It is on this basis that these relationships are expected to be ‘above board’ and why the disclosure of payments and other benefits-in-kind to HCPs to date has been so coolly received. We all expect that, as patients, we’ll get the right medicine at the right time because of the trust and faith we have in a well-trained and knowledgeable doctors, pharmacists or nurses. We all read and hear about new advances in medicine, where companies and their leading research scientists, together with clinicians and healthcare professionals, push the boundaries of what we know about illnesses today, to help find cures for tomorrow.

Very few people would argue that experts from any profession should give their expertise and time for free. Paying HCPs for their collaboration is less of an issue than ensuring that the purpose and outcome of the collaboration is understood. Indeed 85% of BMJ readers recently polled[1] agreed that doctors should disclose payments from industry.

There is absolutely no doubt that the disclosure of payments and other transfers of value to individuals will attract a higher degree of media interest and public scrutiny than the previous disclosures – experience from the US shows us that. But within a short space of time this individual level information will soon also become the norm.

If we take the continued disclosure as bringing industry to where society wants us to be, the more important result of this exercise will be that the benefit to patients and the healthcare system of these relationships is clearer, that people understand how, by working together, we develop and deliver the medicines that have the power to change lives.

This is where both industry and those it works with have the opportunity to increase openness about what these collaborations are achieving and the difference we are making collectively to people’s health and wellbeing. Industry is seizing this opportunity and we hope healthcare professionals will too.

  • The ABPI Disclosure team will be at the annual NICE conference from 13-14 October in Liverpool, England. Please visit us in the exhibition hall to discuss the disclosure of payments to individual HCPs and HCOs in 2016.

[1] 85% of 905 reader polled answered ‘yes’ to the question Should doctors be forced to disclose payments and hospitality from drug companies?

Karen Borrer (ABPI)