Pharmas’ payments to doctors raise concerns about prescription bias and have triggered bribery investigations, too. So, to win patients' trust, transparency matters. And now, AstraZeneca is going beyond its Big Pharma fellows to disclose all its doc payments, even in regions where it's not required.
CEO Pascal Soriot told investors at its annual meeting that his company plans to disclose payments in all countries where it has commercial activities, according to The Times. Several countries, including the U.S., require those disclosures under local regulations.
“[There was] no reason for us not to disclose,” said Soriot, as quoted by The Times of London. “It’s only a question of making sure we have the tools to do it in an efficient and indeed transparent manner. I think we should be able to do it soon.”
Getting all the information together won’t be an easy task, with AZ's far-flung commercial operations and local offices that administer marketing programs. The company is active in more than 100 countries, with about 34,600 employees engaged in commercial activities at the end of 2017. It self-identified six confirmed breaches of external sales and marketing regulations or codes in its annual report.
Most countries don’t require the data and therefore don’t have platforms to collect them. Even where there is a government database, no single regulatory body—healthcare or financial—ask drugmakers to disclose payments made outside its jurisdiction.
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The British pharma and its subsidiaries currently report payments to healthcare professionals and organizations in the U.S., Europe, Australia and Japan, among others, which account for 90% of its total payments. It intends to add disclosures in another 11 countries by the end of 2019, a company spokesman told FiercePharma.
In the U.S., biopharma companies are obligated to report these payments under the Physician Payments Sunshine Act. In 2016, AstraZeneca paid U.S. doctors roughly $45 million in general payments, which usually includes those for speaking and consulting fees, according to data available on the Centers for Medicare and Medicaid Services. That’s compared with about $263 million it paid doctors for research.
The European Federation of Pharmaceutical Industries and Associations Disclosure Code governs those payment reports, but different countries have different platforms. In the U.K., for example, the data are hosted by the country’s pharma lobby group, the Association of the British Pharmaceutical Industry.
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Drugmakers argue they sponsor events to communicate with doctors about the latest developments in medicine, and that they also need doctors’ feedback and advice on their therapies. But payments made to doctors, especially those not related to R&D, have been questioned, with critics saying they compromise doctors’ impartiality and have in many cases become conduits for kickbacks.
One of the most prominent doctor bribery cases featured AZ compatriot GlaxoSmithKline, which was fined $490 million in 2014 by Chinese authorities after the drugmaker was found guilty of paying out bribes to doctors and hospitals to promote its products. AZ itself paid the U.S. Securities and Exchange Commission $5.5 million in 2016 to settle similar charges in China and Russia. A more recent example involves Novartis, which U.S. prosecutors alleged offered doctors fancy meals in exchange for prescriptions.