A new study has revealed significant transparency concerns in the UK's system for disclosing financial relationships between pharmaceutical companies and healthcare professionals (HCPs), highlighting potential risks to patient care and medical decision-making integrity.
Researchers from the University of Bath and Lund University have identified major shortcomings in the Association of the British Pharmaceutical Industry's (ABPI) voluntary Disclosure UK system. Their findings, published in BMJ Evidence-Based Medicine, show that billions in pharmaceutical payments remain inadequately tracked and disclosed.
Scale of Undisclosed Payments
Between 2015 and 2022, pharmaceutical companies made approximately £3.3 billion ($4.1 billion) in research payments through the ABPI system. The study found that major pharmaceutical companies, including AstraZeneca, Allergan, and Bristol Myers Squibb, categorized more than 90% of their HCP payments as research-related, without disclosing recipient details.
An additional £1.1 billion in non-research payments were recorded during the same period. However, despite ABPI code requirements for recipient disclosure, researchers found significant reporting gaps. In Allergan's case, recipient information was available for only about 15% of payments.
Systematic Compliance Issues
Recent compliance breaches underscore the system's vulnerabilities. A notable example involves Novo Nordisk's failure to report £7.8 million in payments to over 150 UK healthcare professionals and organizations, highlighting the broader issues with the current self-regulated approach.
"Our analysis reveals that the public sees only the tip of the iceberg when it comes to drug company payments to healthcare professionals and organisations," says Dr. Piotr Ozieranski, the study's lead author. "Without strong legislation, conflicts of interest will remain hidden, undermining healthcare integrity and potentially putting patients at risk."
Push for Legislative Reform
The researchers advocate for the implementation of a UK version of the US Sunshine Act, which mandates comprehensive tracking and reporting of all financial relationships between medical manufacturers and healthcare providers to the Centers for Medicare and Medicaid Services.
While the UK government's recent consultation on payment transparency represents progress, the study's authors argue that merely refining the existing Disclosure UK program would be insufficient. They emphasize that only legislation with robust enforcement mechanisms can ensure the necessary accountability and transparency.
Industry Response
The ABPI has defended its current system while acknowledging room for improvement. Dr. Amit Aggarwal, ABPI's executive director of medical affairs, states: "Disclosure UK has played an important role in improving transparency in the relationships between industry and healthcare professionals and organisations, and we will continue to evolve it to make it more accessible and comprehensive."
He adds that transparency reporting exists within a broader framework of industry regulation and accountability, emphasizing the pharmaceutical sector's commitment to appropriate collaboration with healthcare stakeholders in patients' interests.
