Yesterday, Roche partnered with nine additional Innovative Medicines Canada members to publish aggregated sums of payments made by our individual companies to healthcare providers (HCPs) and healthcare organizations (HCOs) in Canada. The objective of this reporting was to enhance transparency around our interactions with these stakeholders and to initiate a much-needed dialogue about the investments we, as an industry, make into the Canadian healthcare system, as well as the impact these investments have on the lives of Canadians today and into tomorrow.
Since the release of this data (and in the weeks leading up to its publication), there has been significant media and stakeholder interest in how the pharmaceutical industry is approaching transparency reporting given the lack of regulations mandating this activity in our country. Subsequently, there has been much criticism about the level of detail included in the information we have disclosed.
The press coverage, however, has missed several important points. If we pause to thoughtfully consider the intent of this disclosure, we may be able to quell these concerns and come to a more informed understanding of the best way to meet the needs of health system stakeholders across the country.
The relationship between HCPs, HCOs and the pharmaceutical industry is often subject to scrutiny. The opportunity for one to unduly influence the other’s professional behaviour is cited, time and time again, as the primary reason why these parties cannot and should not collaborate. In our view, this concern is a valid one, but only if a company’s interactions with HCPs and HCOs is left unchecked. And that’s why Innovative Medicines Canada’s Code of Ethical Practices is so instrumental.
Likewise, as an industry, we should be willing to disclose the scope and nature of our interactions with stakeholders. Doing so achieves several important objectives:
- It helps demystify the relationship between healthcare providers and the industry, while improving public understanding of why these relationships are important and how they work;
- It promotes an open and evolving dialogue about what Canadians expect and need in their care; as well as what they expect from innovative pharmaceutical manufacturers, healthcare providers and the system overall; and
- It helps us better serve patients by addressing very clear gaps and barriers within our current system as part of our commitment to innovation and advancing the delivery of quality healthcare.
As Canadians, we should value and continue to encourage collaboration among industry and all health system stakeholders. The fact that we work together should not be reason for concern. But we recognize that what often leads to confusion, or raises questions, is the fact that our collaboration is tainted by misinformation and misunderstanding.
Interactions between companies like Roche and HCPs/HCOs has helped produce innovative medicines and develop novel diagnostics that have fundamentally changed disease treatment and management for Canadians. As the primary point of contact with patients, HCPs offer invaluable expertise on how diseases are managed in real-world settings. This plays a crucial role in informing the pharmaceutical industry’s efforts to improve patient care, treatment options and patient outcomes.
The assumption that HCPs and HCOs who work in collaboration with the pharmaceutical industry are inherently influenced by these collaborations undermines the expertise, experience and knowledge of these stakeholders. We believe that HCPs and HCOs, regardless of their ties to industry, make informed decisions about the use of diagnostics and medicines that are in the best interest of their patients, based on their assessment of the patient case and medical history. In fact, the value of the input and expertise we receive from HCPs and HCOs is in the independence of this thinking.
But, as with any professional group providing services, it is fair and appropriate to remunerate HCPs and HCOs for their time and expertise. And herein lies the challenge – how much do they get paid, by whom, and for what?
To start answering these questions, Roche has voluntarily published data for three key areas: the total each company paid1 to HCPs for services such as speaking and/or consulting; the total each company spent on funding1 to HCOs, which support efforts such as philanthropic (charitable), educational and/or scientific activities; and the total each company spent supporting HCP travel to attend international congresses and/or global standalone meetings.2
Some have suggested, this is a start but it’s still not enough. The way forward, however, is a bit complicated. One consideration that’s important to note is that Canadian privacy laws currently prevent companies from disclosing information about individual recipients without their consent. While we look for ways to enhance this reporting, we must also ensure compliance with Canadian privacy requirements. And though we appreciate the limitations of providing aggregate data, we believe it is currently the best option available to us.
Regardless of the complexity, as industry partners, we are committed to continuing to advance and evolve this framework. Bringing greater transparency to these valuable and well-regulated relationships will increase understanding of the industry’s collaboration across the healthcare sector and contribute to enhancing trust and value within our healthcare system, and most importantly with patients.
June 21, 2017
1. Includes direct and indirect payments or funding
2. As per section 10.4 of the Innovative Medicines Canada Code of Ethical Practices, a Global stand-alone meeting is a scientific exchange meeting (excluding Investigator meetings), organized by the International Affiliate/Global Corporate Head Office of a Member Company, which involves Health Care Professional invitees from many different countries (including Canada) and is usually held in a central location, inside or outside of Canada.