Last week, Telegraph UK published a number of articles based on undercover interviews that targeted the relationships between drug companies and employees of the National Health Service (NHS). The articles noted that that NHS formulary decision-makers may also work as paid company consultants who can recruit other influential NHS employees to advisory board meetings. One interview in particular revealed that these meetings may be held in exotic locations at fancy hotels.
In the United Kingdom, NHS hospital trusts and Clinical Commissioning Groups (CCGs) produce a formulary of medicines deemed preferable for prescribing within a given locality—there are currently 209 CCGs operating in England. Earlier this year, undercover reporters posed as promoters for a drug company, and asked influential NHS health officials how best to get CCGs to switch drug their company’s products.
The article highlighted one board meeting in particular where a pharmaceutical company paid the head of medicines management at the Isle of Wight CCG £5,000 to help organize an event. The company brought 12 payers together in Germany to one of the “top ten hotels in the world.” Speaking to the undercover reporters, the NHS employee noted that each delegate was paid £500 a day to attend and that all of those who were invited “switched” to the drug company’s product after the trip. “We have to be careful not to choose a nice venue just because it’s a nice venue. But it does it does sway people,” he added.
In another case, the formulary development pharmacist at one NHS trust, who has since resigned, advertised that he had a network of more than 100 health service officials who make decisions about what drugs to buy. “I’m talking about the payers who will make a decision on which drug they have on the formulary,” he said in the undercover video. He said he would charge £15,000 to organize an advisory board meeting which would give the company a “competitive edge”. He “offered to set up a trip to Dubai for 10 health officials, many of whom are involved in choosing the drugs their CCG or Trust offers to patients,” states Telegraph.
UK Sunshine Act?
Currently, member companies of the Association of the British Pharmaceutical Industry (ABPI) are required to report transfers of value made to health care professionals to remain compliant with the EFPIA Disclosure Code. However, the Telegraph article notes that NHS England and Jeremy Hunt, the Health Secretary, have noted that the investigation “raised the question of whether the Government should legislate for full disclosure of payments made to health professionals.”
The UK news outlet Independent quoted the Department of Health as stating that “[i]f these allegations are true, this is completely outrageous and amounts to an abuse of the trust that patients place in NHS staff.”
An NHS England spokesman said: “These are extremely serious allegations so we have immediately directed NHS Protect to launch a full investigation of each and every case identified by this press report.”
“These allegations also raise the question of whether this country should now legislate for a so-called Sunshine Act, requiring full disclosure of any payments made by a pharmaceutical or device company to a health professional or NHS employee.”
The scrutiny in these cases focused on employees of NHS, but pharmaceutical companies too must be weary of increased scrutiny into their interactions with payers abroad and potential bribery charges. While patients ultimately benefit when pharmaceutical companies can rely on the expertise of a diverse spectrum of consultants, care must be taken to keep these engagements transparent and avoid the extravagance alluded to here.