Most Australians believe that drug company payments influence doctors’ decisions

A survey sponsored by a drug company indicates that nine in 10 Australians are concerned about the industry’s payments to doctors, though two thirds can be persuaded that such payments are acceptable if fully disclosed.

The representative online survey of more than 1000 people, funded by GlaxoSmithKline (GSK), found that more than 70% of respondents were worried that payments to doctors may influence advice given to patients, 54% believed that the fees compromised a doctor’s integrity, and just over 50% considered the payments a form of bribery.

However, when the questionnaire provided a statement about the reason for the payments, 64% of people said that they were acceptable as long as there was full public disclosure of every payment.

The general manager of GSK in Australia, Deborah Waterhouse, said that the survey’s findings confirmed the public’s expectations of greater transparency. “About two out of three Australians say the payment of fees to healthcare professionals is acceptable so long as the pharmaceutical companies are completely open and publicly declare the fees paid,” she said in a statement.

In another finding of the survey 65% of respondents said that they would view drug companies more favourably if they were more open about their relations with the health professions.

GSK is using the results to push for full disclosure of all payments to doctors in Australia, including benefits such as free meals, and the naming of recipients. A spokesperson told the BMJ, “We are absolute advocates for that.” Asked whether the company would like to see similar comprehensive disclosure in the United Kingdom the spokesperson said, “We’re working towards that.”

The results come as the new Sunshine Act is being implemented in the United States, which requires full public disclosure on a searchable website of every payment over $10 made to every doctor from 2013 (BMJ 2010;340:c1648, doi:10.1136/bmj.c1648).

In Australia drug companies are currently required to disclose only the amount they spend at the 30 000 or so “educational” events each year but not the names of the health professionals who attend or the many payments to “key opinion leaders” for consultancy or advice.

Although GSK has welcomed what it claims to be widespread public support for industry sponsorship as long as it is transparent, a group that is critical of pharmaceutical marketing has questioned whether comments in the survey questionnaire could have led people’s responses in a certain direction.

The survey’s question B3 starts with the statement: “The fees may be paid to help fund medical research, clinical education programs, and provide payments for those that devote time to develop new medicines and advise how best to use them.”

Jon Juredini, a spokesman for Healthy Skepticism and a professor at the University of Adelaide, told the BMJ that in his view the comments in the survey questionnaire had “misrepresented the relationship between industry and doctors as an altruistic one, whereas it is primarily motivated by marketing.”

Asked about the motivations behind the survey, GSK’s head of corporate affairs, Lisa Maguire, said: “It’s about myth busting . . . trying to break down some of the ‘big pharma’ commentary. Once people start to understand what payments are for, they think, ‘This is reasonable.’”