Table 2

Representative quotes for category I: views and experiences of interactions

Transactional nature of relationships
Access programmes, clinical trials and advisory boards‘…to access drugs that are either off-label or compassionate. Or pseudo-compassionate, I think. Having to stump up $60K for a drug is pretty bad.’ (P14)
‘I think being in the good books of pharmaceutical companies often can bring trials as well to the Centre.’ (P11)
‘…building relationships with pharma usually means better research opportunities for the institution.’ (P15)
‘I feel like I learn quite a lot from hearing what’s being discussed round the table [of advisory boards). But, you know, I mean they control the agenda, the drug company, in that context, control the agenda.’ (P6)
Education‘I’m very cautious about using pharma for education.’ (P4)
‘Some of those educational meetings… I feel have value, but they’re obviously problematic because… there is a bias to the way the information is presented. Some of it’s really good information, but there’s a bias to it.’ (P6)
‘I don’t see education as a main role, even though it’s often zhuzhed up to, you know, they say it’s a main role.’ (P12)
Sales representatives‘There was one instance where a drug rep just seemed like a really nice lady… and we were pregnant at the same time, and we just had nice conversations… she did try to talk with me about work stuff as well, of course, because that’s her job.’ (P7)
‘I think it’s important to be aware that it is a transactional relationship… try and recognise the gain that they are getting out of things.’ (P5)
Research dependence and associated risk
‘They want to run trials that, at the end of the day, expand their market, so de-escalation studies and stopping studies, this sort of stuff, is not in the interests of a drug company.’ (P2)
‘If you look at the major studies which are published in large journals, it is very hard to find one that is not sponsored by industry.’ (P5)
‘If the industry or pharmaceutical oversight is such that you don’t find out about certain arms because they weren’t favourable, financially favourable for the company, then that’s hugely problematic.’ (P7)
‘I think that those interactions mean that the companies have their ear and, in fact, have too much power over the research agendas that are being driven.’ (P13)
Ethical challenge of industry payments
Unreasonable circumstances‘I introduced an international speaker and sat down again and they wanted to pay me $1000. I think that’s just excessive, to be honest. I didn’t accept, they’re ones I just haven’t accepted. But I think they’re excessive.’ (P6)
‘I have spoken at a drug company lunch for GPs, and I was given slides to present. And I took about $1000 for it, and I feel like that wasn’t commensurate with the work that I put in, and it was the last time that I did it… I did feel really grubby about it for years after, and even now I’m like ‘s***, I really shouldn’t have done that’.’ (P3)
‘Sometimes they turn out to be an enormously hourly rate, for example, that doesn’t seem very justifiable. You know, if you’re really reimbursing for time that you’ve spent away from your private practice, for example, it shouldn’t be $25 000 for a morning’s work.’ (P12)
Reasonable circumstances‘If you've given time to go and sit on an advisory board, then I think it’s reasonable that that your time should be reimbursed by the company.’ (P1)
‘I think that it would hard to justify asking people to voluntary donate their expertise and their ideas to a major pharmaceutical company for no reimbursement.’ (P2)
‘I’m of the view that if I have spent time at the advisory board, appropriate monetary reimbursement should be made.’ (P11)
‘My kind of perspective on it is that the payment that they’re offering has to be a realistic, in both directions, it has to be a realistic compensation for the time I personally committed to it.’ (P13)
‘I think pharma needs to pay for my time. So if they ask me a question, advice about clinical practice, or ‘what do you guys do for myelofibrosis?’, or, you know.’ (P15)
Attitudes vary based on forms of interactions
Clinical trials‘I think the… kind of interaction that we often don’t think about, which I think is very important, is interacting with them in a more academic capacity. So, for example, talking about trial planning, trial placement at our centre, which I truly believe would actually benefit our patients.’ (P11)
‘If there are trials around or investigator-initiated things, you can access, there may be a benefit for you in that interaction.’ (P14)
‘I’m much more comfortable in my research space… I’m very happy to talk about research.’ (P15)
Access programmes‘…the other reps that I really don’t mind and find very helpful, informative about their access program…’ (P10)
‘…the interactions that I’m most comfortable with, it would probably be drug access programs, where patients can access drugs earlier, because that can offer some clinical benefit to the patient in terms of avoiding cost, or funding it themselves.’ (P5)
‘…where there’s an access program, I feel there’s some value.’ (P6)
Sales representatives‘I’m not interested in them when they come and say ‘buy my drug’, you know, that’s just, that’s pointless.’ (P4)
‘There’s no time that I’m thoroughly enjoying sitting down and hearing it from the rep. It’s often just an excuse to get coffee, if I’m honest.’ (P10)
‘The pure sales reps, to be honest, I really can’t stand them. I hate people coming to talk to me with a slide deck. I hate glossy leave-behinds. I hate emails that look like mass-emails with logo branding and other stuff, I can’t stand that kind of stuff.’ (P13)
  • GPs, general practitioners; P, participant.