By the end of June 2016, EFPIA member companies will disclose payments made to health professionals, such as sponsorship to attend meetings, speaker fees, consultancy and advisory boards. We asked a number of key stakeholders in the healthcare sector to share their views on the EFPIA Disclosure Code, its benefits and potential areas of concern.
Ian Banks, President European Men’s Health Forum (EMHF)
‘Stuff’ happens but history is not always kind over mistakes made in the relationship between industry and the health voluntary sector. Similarly, failure to learn from them carries far greater danger than positive action. Disclosure is possibly the best example of preventing unnecessary ‘stuff’ happening.
Nicola Bedlington, Secretary General, European Patients’ Forum
By the industry’s own acknowledgement public trust in Pharma is low. The health stakeholder community and the public will welcome initiatives that contribute towards building that trust.
So I believe disclosure of value transactions is a welcome, timely and natural development, requiring a lot of time investment and cultural shift to get it right. I do not however think payments to doctors should be banned. In the same way as patients’ expertise and experience is needed in the medicines development life cycle so too, of course, is the doctors and actually both should be appropriately, proportionately and publicly rewarded in a way that is transparent to the public.
Cooperation between industry and patient organisations is also clearly an area rightfully under ongoing scrutiny and the implementation of the EFPIA Code of Conduct for relations between patient groups and industry over the last 10 or so years, with amounts given to POs from companies and the percentage made public on respective websites, has demonstrated that this approach can work.
Multi stakeholder cooperation is also important – the joint work of the European Commission, healthcare professionals, patients, industry, and regulators in the development of Guiding Principles for Good Governance in the Pharma Industry is a case in point – and this is where disclosure of payments to HCP was also mooted a few years ago.
Eva Grut-Aandahl, Head of European Government Affairs, Global Policy and International Public Affairs, Pfizer
We regularly work with healthcare professionals (HCPs) and healthcare organisations (HCOs) who advise us on a range of topics such as medicines development, the role of a medicine in a patient treatment pathway; health economics and clinical best practice. These working relationships are essential to gaining the real-world information we need in order to deliver treatment choices that improve the health of patients and to share information that may be relevant to clinical decision making.
We want people to know, and understand, what we do and how we do it. We are committed to transparency about how we operate as a business and about the relationships we have with HCPs and HCOs. Sharing information about these relationships in a straightforward and open way will, we hope, help explain the critical value these relationships bring to patient management.
We believe that transparency is essential to building and maintaining confidence in us and in our medicines and strongly support the work being done by The European Federation of Pharmaceutical Industries and Associations (EFPIA) to improve transparency across the pharmaceutical industry.
Brennan Jacoby, Philosopher and Trust Consultant, the School of Life
While the failure to disclose information can enable deception and lead to distrust, transparency does not guarantee that well-placed trust will be established. More important to building a lasting, well-established trust is the meaning communicated by any information disclosed. Transparency’s ability to support trust is found not just in its capability to reduce the opportunity for deception, but in its capacity to reveal the trustworthiness of individuals and organisations to others.
Magda Kalata, European Health Parliament
Pharmaceutical companies are under heavy criticism in the current economic environment. By increasing transparency about the sponsorship of HCPs, companies have the opportunity to demonstrate their commitment to the continual education of medical professionals, which, in turn, helps to provide better care to patients. Some criticism may, of course, arise in relation to the associated costs of some sponsorships, but scrutiny of the sponsorship patterns may also help to reduce inequalities by helping to identify gaps in terms of overlooked countries or specialisations. As healthcare stakeholders and policymakers, we can only move forward in building a healthier society if we look at ourselves critically and consider what we can improve in the future, rather than fearing criticism and shying away from change.
Stefan Larsson, Senior Partner and Managing Director, The Boston Consulting Group
My general view is that the highest standards in business ethics and integrity are necessary for a functional market and sustainable value creation. If the authorities, regulatory bodies or public want interactions between industry and health care professionals to be openly disclosed I think that is the right thing to do. Over time, this will ensure that people trust that business is conducted in accordance with good business practice. This will benefit the proactive pharma companies as they in the future will need to work closer with providers in teaming models to jointly secure better results for their patients.
Ima Parrondo, Head of Health Care Compliance Janssen Europe, Middle East and Africa
At Janssen we believe we have a responsibility to support physician education regarding the latest disease and treatment developments in order to help deliver the best results for patients. We do strictly apply EFPIA principles to these interactions, which ensure that the integrity of the treatment decision is never compromised. Nevertheless, we are committed to working with healthcare professionals and healthcare organizations to achieve further transparency in our interactions disclosing publicly the transfer of value we have with them. We believe this is essential to create a climate of trust in which medical advancements can thrive for the ultimate benefit of public health.
Ilaria Passarani, Head of the Food and Health Department BEUC, the European Consumer Organisation
Relationships between pharmaceutical companies and health care professionals are vital and legitimate but to be considered “healthy relationships” they have to be transparent. Full transparency is crucial if we want patients to trust the medicines that are on the market, if we want them to trust their health care professionals and if we want them to have confidence in the health care system. In this context BEUC welcomes the EFPIA Code on disclosure of transfers of value from pharmaceutical companies to health care professionals and healthcare organisations.
We urge all health care professionals and pharmaceutical companies across the EU to comply with the code and we look forward to seeing it properly implemented and enforced in all Member States.
Dr Joanna Robaczewska, Hasselt University
The EFPIA Disclosure Code is an important step towards transparency, which should not be, however, seen as an ultimate goal of disclosure. More important is the purpose of remaining transparent, which, if misunderstood, can disturb substantially the benefits-risk balance of transparency practices as well as influence unfavourably the practice under scrutiny. In this specific case of disclosing transfers of value to HCPs and HCOs it may be beneficial to put the disclosed information in a context that will help to answer the question whether value transfer outcomes are aligned with value creation.
Yasemin Sener, European Health Parliament, (Chair of electronic and mobile health)
Sharing is caring! This saying has never been so meaningful before. In a crucially important issue, “health”, for years stakeholders have seemed to play a game of monologues. Now is the time to share medical data to build a discussion among patients, doctors, the industry and the institutions, to speed the pace of innovation and to save lives.
Clara Zachmann, Ethics & Policy Manager, EGA – European Generic Medicines Association
Trust between stakeholders is essential for better healthcare. Pharmaceutical industry codes, including the code our industry adopted one year ago, set strong ethical standards to ensure trustworthy and transparent relations between industry and the wider healthcare community. Our industry welcomes discussion platforms on Ethics to raise awareness on the benefits of greater transparency afforded by disclosure codes. Through disclosure, the industry, healthcare professionals and organisations and patient associations can jointly promote shared values of transparency, mutual respect, integrity, accountability and collaboration.
For more information on disclosure of payments to health professionals, you can visit www.efpia.eu/disclosure.4