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How big pharma could be influencing your healthcare

14 February 2018
Overdiagnosis and overtreatment linked to sponsored events
Call to rid professional education of commercial sponsorship, as analysis of industry-funded events suggests a link between pharmaceutical marketing and the overdiagnosis and overtreatment of certain conditions.

Researchers from the University of Sydney have analysed four years of Australian pharmaceutical industry-sponsored educational events for health workers dedicated to three conditions prone to overdiagnosis and overtreatment – depression, overactive bladder and osteoporosis.

Published in BMJ Open today, the research reveals that a few companies sponsored the majority of the events, GPs were often targeted, and most events offered attendees dinner. The provision of meals at such events has been shown in previous studies to influence prescribing behaviour.

Dr Barbara Mintzes, lead author and senior lecturer at the University of Sydney’s Charles Perkins Centre and Faculty of Pharmacy, said the findings highlighted the need for professional education to be free from commercial sponsorship.

“We examined over 3,000 events with almost 100,000 attendances by healthcare professionals, from October 2011 to September 2015,” she said.

“Just two companies sponsored over 70 percent of the depression events we identified, another two companies sponsored over 80 percent of overactive bladder events and two companies sponsored nearly 50 percent of osteoporosis events."

We are very concerned Australia’s transparency regulations are not robust enough to provide a full picture of the influence of such sponsorship.
Lead author Dr Barbara Mintzes

“In most cases, the sponsors’ products are not considered the most cost-effective choices for the condition they purport to treat. In fact, several were considered unacceptable for PBS Reimbursement and others have been associated with cost, efficacy and safety concerns internationally," Dr Mintzes added.

“We also examined trends over time in sales and dispensing of lead sponsors’ relevant marketed drugs, but unfortunately could not assess causal links between increased prescribing and event attendance, as no information was publicly available on the identity of individual event participants.” 

The research extends on work by the Charles Perkins Centre’s Evidence, Policy and Influence Collaborative, led by senior author Professor Lisa Bero, and was conducted in collaboration with the Ministry of Health in Indonesia, the University of Insubria and Bond University.

“Earlier this year we developed a new searchable database of transparency reports from Medicines Australia, the pharmaceutical trade association, to enable researchers, journalists and the public to more easily analyse the impact of pharmaceutical industry sponsored events on health professionals,” Professor Bero, from the Faculty of Pharmacy, said.

As we dive deeper into these data, we are finding consistent and concerning levels of marketing aimed at healthcare professionals – concerning because we know marketing influences diagnoses and treatment, and, ultimately, people’s health.
Co-author Professor Lisa Bero

“Pharmaceutical disclosure rules now also explicitly exclude food and beverages from reporting requirements, yet most sponsored events include both. Rather than seeing greater transparency around pharmaceutical marketing and its influences we are likely to experience less.

“In any case, transparency only gets us so far – a separation of education of our healthcare professionals from marketing activity is the ideal.”

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