Pharmaceutical industry funding of events for healthcare professionals on non-vitamin K oral anticoagulants in Australia: an observational study

Abstract

ObjectivesTo describe the nature, frequency and content of non-vitamin K oral anticoagulant (NOAC)-related events for healthcare professionals sponsored by the manufacturers of the NOACs in Australia. A secondary objective is to compare these data to the rate of dispensing of the NOACs in Australia.Design and settingThis cross-sectional study examined consolidated data from publicly available Australian pharmaceutical industry transparency reports from October 2011 to September 2015 on NOAC-related educational events. Data from April 2011 to June 2016 on NOAC dispensing, subsidised under Australia’s Pharmaceutical Benefits Scheme (PBS), were obtained from the Department of Health and the Department of Human Services.Main outcome measuresCharacteristics of NOAC-related educational events including costs (in Australian dollars, $A), numbers of events, information on healthcare professional attendees and content of events; and NOAC dispensing rates.ResultsDuring the study period, there were 2797 NOAC-related events, costing manufacturers a total of $A10 578 745. Total expenditure for meals and beverages at all events was $A4 238 962. Events were predominantly attended by general practitioners (42%, 1174/2797), cardiologists (35%, 977/2797) and haematologists (23%, 635/2797). About 48% (1347/2797) of events were held in non-clinical settings, mainly restaurants, bars and cafes. Around 55% (1551/2797) of events consisted of either conferences, meetings or seminars. The analysis of the content presented at two events detected promotion of NOACs for unapproved indications, an emphasis on a favourable benefit/harm profile, and that all speakers had close ties with the manufacturers of the NOACs. Following PBS listings relevant to each NOAC, the numbers of events related to that NOAC and the prescribing of that NOAC increased.ConclusionsOur findings suggest that the substantial investment in NOAC-related events made by four pharmaceutical companies had a promotional purpose. Healthcare professionals should seek independent information on newly subsidised medicines from, for example, government agencies or drug bulletins.

Trend of anticoagulant therapy in elderly patients with atrial fibrillation considering risks of cerebral infarction and bleeding

“…This could explain our results as well as those reported previously. Meanwhile, Behdarvand et al pointed out that intense sales promotion efforts by pharmaceutical companies to market DOACs toward Australian clinicians might have been a driving force behind the increase in DOAC prescriptions 37 . Although there are no such reports in Japan, since DOACs are more expensive than VKA, we cannot deny the possibility that aggressive offer of information provision by companies may have influenced clinicians’ prescribing behaviors.…”

Pharmaceutical industry payments and assisted reproduction in Australia: a retrospective observational study

“…Although we were not able to analyse the content of these industry-sponsored events, they likely focused on fertility treatments made by the companies, thus promoting their use. 22 23 Pharmaceutical industry sponsored events have been shown to foster overdiagnosis and overtreatment of various conditions, including depression, osteoporosis and over­active bladder syndrome. 24 …”

Global access to affordable direct oral anticoagulants

“…In Australia, direct oral anticoagulant-related events sponsored by the pharmaceutical industry reached 90 000 health professionals over a period of 4 years. 32 By favouring expensive alternatives or unnecessary drug use, promotional marketing can undermine the principle behind essential medicines lists, which is the careful selection of safe and effective medicines. Government agencies should promote independent information on direct oral anticoagulants and control the quality of continuous medical education.…”