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Feature Drug Regulation

Letting the sunshine in on doctor-pharma relationships

BMJ 2011; 343 doi: (Published 11 October 2011) Cite this as: BMJ 2011;343:d6459
  1. Andrew Jack, pharmaceuticals correspondent
  1. 1Financial Times, London, UK
  1. Andrew.Jack{at}FT.Com

Drug companies are increasingly obliged to publish details of payments to doctors. The United States is leading the charge, but are we getting the full story in Europe? Andrew Jack reports

When the drug company Cephalon took 13 British doctors to the European pain congress in Lisbon in September 2009, the expenses it provided did not stop with travel, fees, and accommodation—and its presentations were not limited to a balanced scientific explanation of its products at a day time satellite meeting. An internal feedback document circulated to the sales team at the company (now owned by Teva) described one evening’s festivities that it funded for staff and doctors: “Dinner was fantastic . . . we then went to a few bars and to a club till 3am. All the customers were really looked after and spoke positively about Effentora [fentanyl]—let’s make sure they start Rxg [prescribing] now!”

It was a complaint from a former Cephalon sales representative that triggered an inquiry by the Prescription Medicines Code of Practice Authority, the self regulatory arm of the Association of the British Pharmaceutical Industry. That led to a sharp public rebuke for the company, while providing a rare public insight into the tactics and motivations behind corporate links to doctors.

Such incidents—and many far more troubling and extensive ones exposed and penalised through lawsuits in the US in recent years—have led to increasingly tough codes of conduct being introduced by drug companies around the world, and to calls by politicians and regulators for far greater “sunshine” to highlight their activities.

Similar pressures are now building in Europe. Since 2008, Denmark has required companies to disclose to the Medicines Agency any payments they make to doctors, and even details of extensive “unpaid involvement” such as unremunerated work on advisory boards.1 There have been …

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