Just when regulation in the medical industry appeared to be at its tightest, the Australian Competition and Consumer Commission (ACCC) found a new way to bring even more transparency to the way the drug industry deals with doctors. Like financial planners and the ongoing debate over commissions, the drug industry has faced scrutiny over its methods of marketing products to doctors, with the ACCC spotlight now beaming down on drug-sponsored hospitality for medical practitioners this time around. Pharmaceutical companies, through their umbrella organisation, Medicines Australia, will need to publicly disclose details of free meals, trips or gifts handed out to doctors as part of promoting their products, following a ruling by the Australian Competition Tribunal.
The information companies will need to disclose includes details about the professional status of attendees, the type of hospitality offered, the education provided and the cost of the event. All these details will go online for public viewing on the Medicines Australia website every six months. The tighter conditions come after media reports in The Australian last year of one global drug giant spending $65,000 taking 200 cancer specialists to dinner at the exclusive Guillaume at Bennelong in the Sydney Opera House - a slight stretch on the requirement under the code of conduct for company-sponsored meals to be "simple and modest".
Following the event, the ACCC moved to revise the industry code of conduct to ensure lavish dinners weren't used by companies to influence prescribing decisions. Medicines Australia appealed but was defeated and the ACCC will now get its way. ACCC chairman Graeme Samuel says the move to toughen disclosure rules was necessary to increase the level of transparency around functions sponsored by drug companies.
"The ACCC believed that enhanced transparency would bring about greater accountability on the part of pharmaceutical companies about their sponsorship activities and would help the public to assess whether the code [of conduct] is being effectively enforced by Medicines Australia," Samuel said. That's just like asking consumers to judge how well the FPA is doing in its job of regulating members. The pharmaceutical industry's code of conduct has been in place for almost 50 years and has gone through 15 editions. According to Medicines Australia, it's "one of the toughest in Australia".
It regulates advertising of prescription drugs to doctors, drug company sponsorship of medical conferences, the payment of travel and accommodation expenses of doctors attending conferences and the provision of other forms of hospitality. Like the FPA Principles for Managing Conflicts of Interest adopted in mid-2006, the code is there to help members carry out their work while staying mindful of what is considered inappropriate practice. Put simply, it means little room for excuses - no-one can claim ignorance when the rules are made clear in black and white.
The FPA has worked hard to ensure conflicts of interest are removed and consumers are protected when placing the health of their finances in the hands of a planner. Developing and upholding codes and guidelines create consumer confidence and this is a win-win all round. However, with every set of rules might come an inquisitive individual or organisation that tries to find new ways to push the boundaries. It's the potential for grey areas that the tribunal has sought to redress in its recent decision. Medicines Australia chief executive Ian Chalmers was clearly disappointed about the ruling, saying that while it would abide by the decision, the industry didn't feel the changes added anything to the "the already large public benefit provided by our strong code of conduct".
But in the tribunal's opinion, the existing enforcement mechanism, so far as it relates to drug companies providing hospitality and other benefits to healthcare professionals, is weak and open to lenient interpretation. "There is little in the way of any real deterrent to contravention or incentive to compliance. There seems to be little incentive or enthusiasm for companies to complain about one another in this area," it ruled. The tribunal also stated that "there is a real risk that absent any requirement for regular reporting and public disclosure of the kind proposed in the ACCC condition, some companies will test the boundaries and offer inappropriate benefits to healthcare professionals".
That very comment is cause for concern. It hints that despite all efforts to bring the industry into line - and likewise the work in educating doctors on ethical conduct when dealing with drug companies - there remains a lack of trust from regulators of the industry. Instead, the tribunal is leaving it up to the public to make sure the big players toe the line. And, really, there is a valid argument for that approach. Notice how kids are better students when the teacher's watching and how employees are better workers when the boss is in the room? People work out at the gym that little bit harder when the trainer walks by and - for those dedicated enough to healthy eating to fill out a calorie-counting diary - the 3pm sugar fix suddenly gets switched for raw nuts when the day's food consumption needs to spelled out on paper. Why? Because no-one likes to appear to be doing the wrong thing - even those who know they might be pushing the boundaries.
