Germany's doctor payment transparency effort relies on honesty

A German nonprofit is collecting information on pharma's payments to doctors, hoping doctors will be honest enough to attach their names to the euro figures, but only about 30% are willing so far.

In the U.S., the Open Payments database lays out pharma's payments to doctors for all to see. In Germany, where disclosure isn't mandated as it is in the U.S., a nonprofit is trying transparency based on the honor system.

German doctors will be able to voluntarily disclose contributions from pharma in a database compiled by the nonprofit journalism organization Correctiv, according to Germany’s DW. About 71,000 doctors in the country received €575 million in cash or in-kind contributions from the drug industry last year, a Correctiv investigation found in December.

That's far less than the $7.52 billion that drug and device makers funneled to doctors and healthcare providers in the U.S. in 2015, the most recent data available, but slightly more than the £345 million that changed hands in the U.K. Making those payments public at the doctor-by-doctor level is important, advocates say, because studies show financial relationships between drugmakers and doctors can affect physicians' prescribing habits.

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Unlike in the U.S., German or European law doesn’t require docs to disclose industry contributions. Correctiv and Spiegel Online found that only 29% of doctors in the country were willing to have their pharma payment info published as of the December report. Correctiv is now making that voluntarily reported data public.

The development comes just days after a study presented at the annual meeting of the American Society of Clinical Oncology found that physicians compensated by pharma companies are more likely to prescribe the individual drugmakers’ treatments for renal cell carcinoma and chronic myeloid leukemia.

The compensation figures for that study came from the Open Records database, a searchable collection of U.S. doctor payments reported by drug and device makers under the Physician Payments Sunshine Act. That law, which took effect in 2013, was prompted by a series of scandals at medical schools where physicians who'd collected hundreds of thousands of dollars from drugmakers were accused of conflicts of interest.

RELATED: Latest Sunshine Act fact? Drug and device makers shelled out $6.5B to docs, hospitals last year

For the first full year after the database went public, total industry payments and investment opportunities offered to doctors amounted to $7.46 billion. The next year, in 2015, the U.S. number grew slightly to $7.52 billion. Full-year numbers for 2016 haven't yet been released.

The payment disclosure mandate is no longer unique to the U.S. Officials in the U.K. have set up Disclosure UK to provide the same type of transparency; that system went live last June. For all of 2015, drug companies disclosed £340 million in contributions to doctors in the U.K., according to the Financial Times. 

Disclosure UK is part of an initiative across Europe to bring transparency to the pharma industry’s relationships with doctors. Compliance in most countries is voluntary, however, so the data are spotty.