miércoles, 4 de abril de 2018

"Sol y sombras" sobre pagos de la Industria Farmacéutica en Europa...


Relationships between health professionals and pharmaceutical manufacturers can unduly influence clinical practice
These relationships are the focus of global transparency efforts, including in Europe. We conducted a descriptive content analysis of the transparency provisions implemented by February 2017 in nine European Union (EU) countries concerning payments to health professionals, with duplicate independent coding of all data. 
Using an author-generated, semi-structured questionnaire, we collected information from each disclosure policy/code on: target industries, categories of healthcare professionals covered, scope of payments included, location and searchability of the disclosed data.

Our analysis shows that although important improvements have been put in place in the past few years, significant gaps remain in disclosure requirements and their implementation
The situation differs substantially from country to country and the most striking differences are between governmental and self-regulatory approaches, especially with regard to the comprehensiveness of the disclosed data. In many cases, individuals can still opt out and reporting is incomplete, with common influential gifts such as food and drink excluded. 
Finally, in several countries data are only available as separate PDFs from companies, thus making the payment reports difficult to access and analyse. In order to overcome these gaps, minimum standards for disclosures should be implemented across Europe. 

All payments to healthcare professionals and organizations should be included, all health-related industries should be required to submit reports, and usability of disclosed data should be guaranteed

Beyond Transparency 

Transparency reporting is an important and necessary step but it is not a solution to undue influence from industry financing of health professionals. Such influence has been demonstrated both in relation to funding of ‘key opinion leaders’ via advisory board membership, speaker fees and contracts, and the ubiquitous everyday gifts of food and drink and invitations to events that feature in transparency databases. 

There is also some evidence of a “dose-response” in the relationship between funding and prescribing rates, with higher prescribing costs and more brand-name prescriptions among physicians in the highest quintile of industry funding, as well as increased prescribing of promoted products in relation to the numbers of meals received.

Ver también: 
Pharma payments to docs in Europe are often inadequately reported or hard to find / Ed Silverman

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