Disclosing drug companies payments should be compulsory, say top earners

The doctors who declared the most earnings from drug companies in the United Kingdom’s new database have said that being transparent about payments should be mandatory.

The database showed that 70% of healthcare professionals who received payments from drug companies agreed to have the information disclosed on Disclosure UK (www.disclosureuk.org.uk), which is hosted by the Association of the British Pharmaceutical Industry. But the 30% who didn’t agree to disclosure received more than half (52%) of the payments registered.1

From the data posted it is possible to find the top earners, but because of the way that the undeclared data are presented it is not possible to tell how they rank overall.

Ian Pavord, professor of respiratory medicine and researcher at Oxford University, declared the most income from drug companies, with £98 000 (€116 778; $130 105) from AstraZeneca, Chiesi Ltd, GlaxoSmithKline (GSK), Roche, and Teva UK Ltd.

He told The BMJ, “I’m keen to be open about this—I don’t feel like I have anything to hide. I’m proud of the work I’ve done with GSK to get a new class of asthma treatment onto the market. It’s taken 10 years of working weekends and evenings, and it’s reasonable to be paid for doing that work.”

Most of the money Pavord received was for work as an expert witness on a patent case and for helping GSK seek regulatory approval for the drug he helped develop. “35% of the money declared was for airfares for visiting the [US] Food and Drug Administration,” he said.

John Gribben, professor of medical oncology at Barts Cancer Institute, was the second highest earner among those who made declarations. He received £90 000 from AbbVie, AstraZenica, Celgene, Gilead, Jansess-Cilag, and Roche for a range of activities from research to participating in advisory boards.

He said that the information included on Disclosure UK was not as good as that available through the Sunshine Act in the US. Since September 2014 US drug and device makers have been required to post payments to physicians and teaching hospitals that exceed $10 on a public database.2 Gribben called for similar mandatory disclosure in the UK.

“Opting out is not right, why would you? Those opting out potentially have something to hide,” he said.

He added, “Lumping activities together makes it unclear what has been paid for. I’d like as much transparency as possible—unambiguous as to what the money is for—this data is not there yet, but it’s a step in the right direction.”

Brian Lipworth, professor of respiratory disease at the University of Dundee, declared the £97 000 he received from Teva UK Ltd for a series of educational lectures on prescribing generic beclomethasone.

Having been profiled in the press on the basis of his disclosure, Lipworth was concerned that the lack of detail in these declarations may “put [other doctors] off from declaring.”

He told The BMJ that he would welcome greater transparency and compulsory registration.

“I only know of one or two academic pulmonologists who don’t do this,” he said. “What have I got to hide, why wouldn’t you [disclose] . . . unless you have something to hide, or an agenda to push through.”

Lipworth was also pragmatic about the need for interaction with drug companies in the current research climate. “90% of my funding comes from industry—I’d love to be totally funded by the MRC [and other funding bodies], but only one in 20 applications are successful.”