BMJ  2007;335:12-13 (7 July), doi:10.1136/bmj.39262.516806.DB

News

Drug industry loses bid to block disclosure of doctors' gifts

Canberra

A court ruling has upheld the validity of a requirement that member companies of Australia's leading lobby group for the drug industry disclose details of hospitality provided at "educational" events for doctors.

In July 2006 the Australian Competition and Consumer Commission approved a revised self regulatory code of conduct developed by Medicines Australia, with the proviso that member companies submit details of hospitality provided and that the data be made publicly available on the group's website (BMJ 2006;333:278, doi: 10.1136/bmj.333.7562.278-b).

Subsequently, Medicines Australia lodged an appeal with the Australian Competition Tribunal, disputing that the additional requirements would be of public benefit and proposing that the code be approved for five years rather than three.

In its judgment, the tribunal noted that the code of conduct monitoring committee, which reviewed materials for more than 4700 events held between 2003 and 2005, lacked rigour. "Given the volume of events and the nature of the Monitoring Committee process," the tribunal judges wrote, "it is difficult to avoid the conclusion that it does not provide a particularly effective check on pharmaceutical company hospitality to healthcare professionals."

The tribunal also noted the inability of the code secretariat to initiate their own inquiries or require materials on events to be provided.

The tribunal determined that there was a risk that "prescribing decisions may be affected or influenced by considerations not relevant to patient welfare. It also carries with it a risk of reduced public confidence in the industry and the profession."

The tribunal upheld the Australian Competition and Consumer Commission's disclosure amendment, with minor modification, but also required that the monitoring committee be able to obtain materials and start complaints. The drug industry's only legal success was in having the duration of the code extended from three to five years.

David Henry, professor of clinical pharmacology at the University of Newcastle, New South Wales, who stood as witness for the commission, says that the tribunal's decision is a useful step towards greater transparency but still falls well short of identifying the doctors who receive hospitality from drug companies.

"The challenge now is for the medical profession to be as equally transparent . . . If the Australian Medical Association and the various medical colleges requested Medicines Australia to go for full disclosure, they might well agree."

John Gullotta, associate professor and the chairman of the therapeutics committee of the Australian Medical Association and a member of the committee adjudicating code complaints, dismissed the suggestion that individual doctors attending meetings be identified, preferring instead that the public "have a bit of trust in the profession." The new disclosure requirement, he said, is a "little bit of overkill."

A spokeswoman for the Ministry for Health and Ageing, Tony Abbott, would not comment on the detail of the ruling, insisting only that it was a matter between the Australian Competition and Consumer Commission and Medicines Australia.

Medicines Australia described the tribunal decision as "disappointing" but has ruled out a further appeal. The first reports are likely to be posted to its website in the first quarter of 2008.

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The decision is at www.austlii.edu.au/au/cases/cth/ACompT/2007/4.html.

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