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Abstract
Objectives To examine the accessibility and quality of drug company payment data in Europe.
Design Comparative policy review of payment data in countries with different regulatory approaches to disclosure.
Setting 37 European countries.
Participants European Federation of Pharmaceutical Industries and Associations, its trade group and their drug company members; eurosfordocs.eu, an independent database integrating payments disclosed by companies and trade groups; regulatory bodies overseeing payment disclosure.
Main outcome measures Regulatory approaches to disclosure (self-regulation, public regulation, combination of the two); data accessibility (format, structure, searchability, customisable summary statistics, downloadability) and quality (spectrum of disclosed characteristics, payment aggregation, inclusion of taxes, recipient or donor identifiers).
Results Of 30 countries with self-regulation, five had centralised databases, with Disclosure UK displaying the highest accessibility and quality. In 23 of the remaining countries with self-regulation and available data, disclosures were published in the portable document format (PDF) on individual company websites, preventing the public from understanding payment patterns. Eurosfordocs.eu had greater accessibility than any industry-run database, but the match between the value of payments integrated in eurosfordocs.eu and summarised separately by industry in seven countries ranged between 56% and 100% depending on country. Eurosfordocs.eu shared quality shortcomings with the underlying industry data, including ambiguities in identifying payments and their recipients. Public regulation was found in 15 countries, used either alone (3), in combination (4) or in parallel with (8) self-regulation. Of these countries, 13 established centralised databases with widely ranging accessibility and quality, and sharing some shortcomings with the industry-run databases. The French database, Transparence Santé, had the highest accessibility and quality, exceeding that of Disclosure UK.
Conclusions The accessibility and quality of payment data disclosed in European countries are typically low, hindering investigation of financial conflicts of interest. Some improvements are straightforward but reaching the standards characterising the widely researched US Open Payments database requires major regulatory change.
- ethics (see medical ethics)
- health policy
- protocols & guidelines
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. We have included all relevant data as supplementary information forming part of this submission.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. We have included all relevant data as supplementary information forming part of this submission.
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Footnotes
Contributors PO is a Senior Lecturer at the Department of Social and Policy Sciences, University of Bath. PO conceived and wrote the paper, collected and analysed the data. PO is the guarantor of the paper. LM is a data scientist and the President of the Euros for Docs Association. LM created the eurosfordocs.eu database, analysed the data and contributed to writing. P-AJ formerly presided the Euros for Docs Association. P-AJ collaborated with LM on creating eurosfordocs.eu. P-AJ conceived the paper and contributed to writing. SM is an Associate Professor at the Department of Sociology, Lund University. SM conceptualised the paper and contributed to writing.
Funding This work was supported by The Swedish Research Council (VR), grant number 2020-01822 ('Following the money: cross-national study of pharmaceutical industry payments to medical associations and patient organisations').
Competing interests We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: PO’s PhD student was supported by a grant from Sigma Pharmaceuticals, a UK pharmacy wholesaler and distributor (not a pharmaceutical company). The PhD work funded by Sigma Pharmaceuticals is unrelated to the subject of this paper. LM and PAJ are members of Euros for Docs, a non-profit organization registered in France that seeks to promote transparency of drug company funding in the healthcare sector by making payment data accessible and complete across Europe. PAJ is employed by Haute Autorité de Santé, the French independent health technology assessment organisation. SM’s partner is employed by PRA Health Sciences, a global Contract Research Organization whose custumers include many pharmaceutical companies.
Provenance and peer review Not commissioned; externally peer reviewed.
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