Letters
Ethics
Volume 190 - Issue 8

Patients expect transparency in doctors’ relationships with the pharmaceutical industry

Authors:  Brad S Dalton and Deborah J Richards

Med J Aust 2009; 190 (8): 459-461. || doi: 10.5694/j.1326-5377.2009.tb02506.x
Published online: 20 April 2009
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To the Editor: We support the findings of Tattersall and colleagues relating to the disclosure of competing interests by general practitioners to their patients, and we agree that greater transparency in general is required with physician–industry relationships.1 Such relationships have the potential to enhance patient outcomes through quality use of medicines. However, in the interests of a balanced perspective, several points regarding Tattersall et al’s article warrant attention.

First, the 2007–08 BEACH (Bettering the Evaluation And Care of Health) survey suggests that the mean length of GP consultations in Australia is 15.1 minutes.2 Considering this, an adequate discussion or disclosure of industry links to each and every patient is simply not practical. Furthermore, the frequency with which GPs see industry representatives can vary greatly. Given these complexities, perhaps clinics could consider having a simple sign in the waiting room that states “We do/do not see pharmaceutical industry representatives”. Disclosures would be most valuable if interested parties agreed on definitions for categories of relationships and payments, uniform approaches to calculating amounts, and standards for information to be made public. Inconsistent practices could create the impression that some practices are being hidden.3

Second, we want to highlight the potential benefits of physician–industry collaborations. We recently organised a panel of Australian physicians to advise a pharmaceutical company on research initiatives that need to be undertaken in a highly specialised area of medicine. An Advisory Group Charter, describing the purpose of the group, desired outcomes, and remuneration, was developed and agreed upon by all members. In this case, physicians received remuneration for time spent reviewing documents and collecting information for the meeting, and to cover costs associated with non-attendance at clinic. The aim of the Charter and two-way confidentiality agreements was to ensure transparency. After reviewing the published literature, each physician shared information about treatment practices and outcomes. The physicians identified several areas that require further research and have the potential to enhance patient outcomes in the immediate future. However, they suggested that these initiatives could be undertaken without industry support. They advised the company to direct its research funding towards large, population-based research initiatives. This is just one example of how transparent collaborations can result in enhanced patient outcomes and a redirection of funding into areas of greatest need.

While we agree that increased transparency is important for physician–industry relationships, and improvements can be made through such avenues as disclosure, a retreat from physician–industry collaborations is not in the interests of improved patient outcomes or enhanced quality use of medicines.

Authors

  • Brad S Dalton1
  • Deborah J Richards2
  • 1. School of Human Life Sciences, University of Tasmania, Launceston, TAS.
  • 2. Gilead Sciences, Melbourne, VIC.

Correspondence: Brad.Dalton@utas.edu.au

Competing interests

Brad Dalton has received consultancy fees from Amgen Australia, Sanofi-Aventis, Roche Products, AstraZeneca, Actelion Pharmaceuticals, Peter MacCallum Cancer Institute, the Australasian Gastrointestinal Trials Group, Gilead Sciences, the National Stroke Foundation of Australia, and Renal Research Tasmania. He was also involved with coordination of the meeting described in this letter. Deborah Richards is employed within the pharmaceutical industry.

References

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