A group of transparency advocates in New Zealand has been writing various articles on the value of “more Sunshine” for a while now. Last Friday, they made their campaign more official with an editorial in the New Zealand Medical Journal. In it, a collection of five academics and doctors argue that New Zealand needs a Sunshine Act comparable to the United States.
"Whilst several countries are enacting legislation to tighten requirements for disclosure ... the situation in New Zealand remains as murky as ever,” state the group of writers, led by Cindy Farquhar, a professor at the University of Auckland in obstetrics and gynecology, and co-chair of the Cochrane Collaboration.
"It is not uncommon for doctors and researchers to receive payment for membership of advisory boards, speaking at industry-sponsored symposia, or sponsorship of travel to and accommodation at conferences, which often incorporate generous hospitality events and may not involve any speaking commitment,” state the authors. The editorial also targets clinical guidelines, given their key role in supporting clinical decision-making.
In addition to Professor Farquhar, the authors of the editorial included: Tim Stokes, Elaine Gurr Professor of General Practice & Rural Health, Dunedin School of Medicine, University of Otago, Dunedin; Andrew Grey, Associate Professor of Medicine, University of Auckland; Mark Jeffery, Medical Oncologist, Canterbury Regional Cancer & Haematology Service, Christchurch Hospital, Christchurch; and Peter Griffin, Manager, Science Media Centre, Royal Society of New Zealand, Wellington.
Last year, Professor Farquhar spoke on the issue of physician payments in a presentation entitled “Does New Zealand need a Sunshine Act?” She stated that doctors are receiving gifts and benefits from industry without having to declare them, including conference travel not related to speaking and generous hospitality. Farquhar argued that such hospitality is “generally aimed at leaders in their field,” including academics, clinical directors, and prominent doctors. She listed a number of examples in her presentation, such as a recent conference in the US where several doctors from New Zealand received free travel, hotel, meals, and conference registration valued at $6,000 per person. She also critiqued a recent New Zealand conference where the sponsor "hosted free evening function for all the clinicians (not the epidemiologists!) which was not on the conference programme,” with an “estimated costs per person $180 X 300 = $54000.”
Farquhar is critical of Medicines New Zealand, the country’s pharmaceutical industry association. New Zealand policy is “soft” because it is self-regulated and non-transparent, she argues. She noted that “hospitality at conferences is alive and well,” and “offers of free travel to meetings/symposia are plentiful.”
In December last year, Medicines New Zealand noted that disclosure of payments from pharmaceutical companies to clinicians would be complex and resource-intensive, as reported by New Zealand's "Pharmacy Today" publication. But the association "stopped short of saying New Zealand should not have a Sunshine Act, and said it wanted to be more involved in discussions." Heather Roy, chair of Medicines New Zealand, stated that the industry's "Code of Practice already has rules around gifts and payments from pharmaceutical companies to healthcare providers" and that the "primary objective of interactions between members and healthcare providers must be to improve patient care, by increasing medical knowledge and enhancing the quality use of medicines."
In addition to disapproving of Medicines New Zealand, Farquhar was also critical of Medicines Australia, which even added a transparency reporting requirement to its code last year. Farquhar stated that Medicines Australia considered "making mandatory reporting how much pharma spends on hospitality and advisory boards," but included an "opt out" for health professionals. Indeed, like much of Europe, Australia is concerned with physician consent before publicizing personal information. According to the new code provisions, "[I]f a healthcare professional does not agree to the information being disclosed with their name, the expenditure will be reported in aggregate with the number of healthcare professionals it relates to."
Read Medicines Australia's description of their updates to the code, including the reporting provisions, here.
An editorial in New Zealand Medical Journal is certainly no Sunshine Act, but the push for transparency--and almost an "expectation" of companies to report physician payments--has taken hold worldwide. Articles in various New Zealand news outlets have steadily been drumming up the importance of more disclosure. It is not difficult to imagine, given the EFPIA disclosure code in Europe, Medicines Australia's transparency updates, and a host of other international "Sunshine" developments, that New Zealand could soon be the latest to join the club.