Ben Goldacre, academic lead at the Evidence Based Medicine DataLab at the University of Oxford, who helped The BMJ with the analysis of data from Disclosure UK (www.disclosureuk.org.uk), the new website detailing payments to doctors from the drug industry,1 has criticised the website for its partial attempt at transparency.
“Doctors have an obligation to be open with their patients and colleagues,” he said. “A financial conflict of interest does not necessarily mean somebody is biased, and there are good reasons to work with the industry, but it does introduce risks. That’s why clearly declaring your conflicts matters, so we can all judge for ourselves.
“There is a pattern of people avoiding responsibility in this area, which is puzzling. The ABPI [Association of the British Pharmaceutical Industry] says that doctors can decide if they want their payments disclosed. NHS England says companies should refuse to work with doctors who won’t disclose. They should both show some leadership. GSK have said that they will only work with doctors who disclosed their payments, and they’ve now said they’re stopping many classes of payment, such as fees for lectures. Other companies could do the same.
“And NHS England, along with the GMC, could simply tell doctors they must disclose. That is important, because pharma payments are not the only payments that matter. Doctors in clinical commissioning groups, for example, often commission health services from private companies they themselves own. Instead of chaos, and multiple partial disclosures spread around the web, all these payments and financial interests should be in one place. The GMC and the government could, and should, require all doctors to post all health related financial interests to a central register. Short of that, we have only the illusion of transparency.”
Problems with Disclosure UK
Only 48% of the specific payments have been linked to individuals or institutions.
Undisclosed payments are published as an aggregate, rather than being listed but anonymised.
The aggregate figures for undisclosed payments combine payments to individuals and those to institutions, although those to institutions are an order of magnitude larger. Organisations opting to hide payments they’ve received from a drug company, such as universities, seem to be included in this dataset.
The way data are shared is unhelpful. For example, it is impossible to calculate, whether by company or from the total, the average size of each hidden payment to a doctor.
There is no indication of what drug or disease area the undisclosed payments relate to.
There are technical problems with the spreadsheets. The numbers on individual payments didn’t seem to add up correctly and didn’t tally with the summary numbers on payments and withheld payments.
The documentation is incomplete, even on simple matters such as what some of the fields in the spreadsheet mean.
The ABPI did not reply to questions about the data. That’s bad practice for anyone sharing any dataset.
The data are shared under a non-standard licence that is unclear but that might forbid reasonable reuse.