Concern over drug company gifts to doctors
New Zealand doctors and nurses accepted drug company-funded trips, meals and gifts worth almost $170,000 last year, amid growing concern about the payments’ potential to influence medical decisions.
District health board (DHB) gift registers obtained under the Official Information Act show health workers accepted 109 drug company ‘‘gifts’’, including overseas trips flying business class.
The largest gift, from Novartis to an Auckland doctor, was $13,500 in flights and accommodation, to attend a four-day osteoporosis meeting in Rome.
Drug companies also hosted meals, including Roche and Gilead spending $6400 for two ‘‘educational dinners’’ for 35 Auckland haematology staff.
One Wellington intensive care doctor was paid a $2500 honorarium for one day’s work advising Baxter Healthcare.
The declared gifts are likely to be only a fraction of the total spent by pharmaceutical companies, as gift registers do not cover private doctors.
Despite Health Minister Tony Ryall’s 2012 assurances that DHBs would standardise their approaches to declaring drug company gifts, policies still varied widely.
Some DHBs had no gift register. Others had registers, but with nothing declared. Waitemata DHB’s 6800 staff declared just one ‘‘gift’’ in 12 months – a tapa cloth given to its chief executive.
The Canterbury DHB said it did not have a gift register but required staff to file conflict of interest or hospitality declaration forms.
The DHB was unable to provide information about the declarations it had received because it did not collate the forms in a single central location, but said a review was under way ‘‘with the intent of creating a single electronic register in the near future’’.
The CDHB did allow a limited amount of sponsored medical education and allowed drug company representatives to visit staff on DHB grounds, it said.
The West Coast DHB did not keep a gift registry either, but said it had recently begun a process to adopt the CDHB’s approach. Both the CDHB and WCDHB were unable to provide further comment about the issue yesterday.
Around the world, countries are demanding greater transparency of payments to doctors, as research has shown drug company largesse influences medical decisions.
Christchurch Hospital Medical Staff Association chairwoman Ruth Spearing said some staff preferred using company funding instead of DHB funding, as it left more money for direct patient care.
‘‘If just one company supported the travel it would create a conflict of interest and we wouldn’t regard it as ethical. We are very careful to ensure that this isn’t the case,’’ she said.
Spearing noted that many doctors were not prepared to engage with drug companies though, due to personal ethics.
Australia’s pharmaceutical industry body Medicines Australia now declares how much it spends on hospitality and advisory boards. In the US, people can search a public database to find out whether a doctor has accepted drug company money, and how much.
Medical Association president Mark Peterson supported a similar public national register here, but would not advocate banning doctors and nurses from accepting drug firm sponsorship.
Waikato associate professor of psychiatry David Menkes has researched doctors’ relationships with drug companies. He advocated outlawing company-sponsored education at public health sites, because of the risk of bias. At present, half the country’s health boards allow sponsored sessions on site.
‘‘It’s not worth the risk. [ ... ] If you follow the money, they’re getting some return on that investment.’’
Medicines New Zealand chairwoman Heather Roy said drug company payments to doctors were regulated by a strict code of conduct.
Auckland: 17 drug company* gifts declared, worth $32,592. The only health board to identify gift recipients.
Capital & Coast: Seven drug company gifts declared, worth $9445.
Canterbury: Staff must file conflict of interest forms, but no register kept.
West Coast: No register kept.
Southern: 56 drug company gifts declared, worth $80,690.
Taranaki, Whanganui, Wairarapa, Nelson-Marlborough, South Canterbury: No gifts declared.
*"Drug company" includes medical device makers.