eshlsg consultation-results-october2013
DESCRIPTION
The ESHLSG has published the results of the recent consultation in to the public disclosure of payments to health professionals.TRANSCRIPT
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Prepared for: Ethical Standards in Health & Life Sciences Group
By: Jane Fligelstone – The Consortium and Nicky Taylor – Taylor McKenzie
REGISTER OF PAYMENTS – CONSULTATION SURVEY
• To assess reactions of Individuals, Commercial and Healthcare Organisations
towards the scheme outlined in the Register of Payments Consultation
document
• And in particular, issues of:
• Transparency and public declaration of payments, in a publicly searchable database
• Who should host the scheme and what role HCPs should play
• Whether payments from all types of Life Science companies should be included
• To understand the potential impact that public disclosure of payments could
have on Individuals’ collaboration with Commercial Organisations
Objectives of the Survey
NB: This consultation has been funded by the ABPI.
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Methodology
Quantitative
Online Survey
1055 responses Including 2 not completed online – BMA and RCGP
Timings
Survey live
28th January – July 5th 2013
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Overall Sample Total Response 1056
Individuals (40+ mentions) 981
• Secondary Care Doctor Excluding Psychiatrists 500
• Psychiatrists 185
• GPs 75
• Pharmaceutical Company Employees 63
• Doctors in Commercial Organisation 47
• Other Individuals 111
Commercial Companies 64
Healthcare Organisations (large) 8*
Healthcare Organisations (small) 3
* Includes two
questionnaires not done
online, not included in
quantitative analysis
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sample of Healthcare Organisations Healthcare Organisations (large) 6
• British Medical Association *
• Royal Society of General Practitioners *
• Royal College of Physicians
• British Pharmacological Society
• Guild of Healthcare Pharmacists
• College of Optometrists
Private Healthcare Organisations (large) 2
• BUPA Health and Wellbeing
• AXA PPP Healthcare
* Includes two
questionnaires not done
online, not included in
quantitative analysis
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sample of Healthcare Organisations
Healthcare Organisations (small) 2
• Bedfordshire Clinical Commissioning Group
• Heathway Medical Centre
Private Healthcare Organisations (small) 1
• HSC Innovations
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Other Individuals in Sample
Individuals - not already shown:
• Allied Health Professional 7
• Nurse 3
• Pharmacist 2
• Medical Devices / Diagnostics Company Employee 11
• Healthcare Manager 2
‘Other’ Individuals (not coded):
86
• Academic / Research in Medicine
• Retired
• Consultant in Pharmaceutical Sector
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sectors of Commercial Organisations
47%
31%
8% 14%
Commercial Organisations
Devices Pharmaceutical Bio-Pharma Other
What sector does your organisation/company belong to? N=64
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sectors of Healthcare Organisations
Large Healthcare Organisation - 6
Small Healthcare Organisation - 2
Large Private Healthcare Organisation – 2
Small Private Healthcare Organisation - 1
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Membership of Individuals in Sample
9%
12%
16%
20%
56%
59%
0% 20% 40% 60%
RCGP
Faculty of Pharmaceutical Medicine
The Royal Society of Medicine
Royal College of Psychiatrists
Royal College of Physicians
BMA
Individual membership (top 6 organisations)
Base: 955 Individuals
REGISTER OF PAYMENTS – CONSULTATION SURVEY
• Statistical analysis has been conducted across each respondent type:
• Individuals, Commercial Companies and Healthcare Organisations
• Positions of Individuals (HCP, Company employee etc.)
• Whether HCPs work in NHS or private practice
• Membership of different organisations
• Sector of company
• Comments have been added to slides where statistically significant
differences were evident at a 95% level of confidence
Statistical Analysis
Results REGISTER OF PAYMENTS – CONSULTATION SURVEY
REGISTER OF PAYMENTS – CONSULTATION SURVEY
CHALLENGES
FACING PSME
Issue of Transparency
and Public Declaration
Single, Searchable Database
Host for System
HCP Involvement
Whether applicable to
all Life Science
Companies
Effect on Collaboration
Scope of Consultation
Should payments from
commercial organisations to
individually named health care
professionals be transparent?
89% 3% 7% Total
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Transparency of Payments Almost universal agreement that payments should be transparent
Q1: Do you agree or disagree with the principle that payments from commercial organisations to individually named health care professionals should be transparent? Base: Total sample – 1054
Agree/strongly Neutral/Don’t know
Disagree/strongly
No difference in views of different respondent type
BMA and RCGP agree
Should payments from
commercial organisations to
individually named health care
professionals be publicly
declared?
77% 9% 15% Total
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Public Declaration Widespread agreement that payments should be publicly declared
Q2: Do you agree or disagree with the principle that payments from commercial organisations to individually named health care professionals should be publicly declared ? Base: Total sample – 1054
Agree/strongly Neutral/Don’t know
Disagree/strongly
No difference in views of different respondent type
BMA and RCGP agree
Should system of disclosure take
form of single, publicly
searchable, central database?
79% 17% 4% Total
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Single, Public Database Widespread agreement that disclosure should involve central, public database
Q3: Do you agree or disagree that a system of disclosure of payments should take the form of a single, publicly searchable, central database? Base: Those who strongly/agree or neither agree nor disagree that payments should be publicly declared (Q3) – 888
Agree/strongly Neutral/Don’t know
Disagree/strongly
No difference in views of different respondent type
Those in the Faculty of Pharmaceutical Medicine statistically less likely to
agree (71%) vs. those in BMA (81%)
BMA and RCGP agree
Who should host any system for
declaring payments?
9%
40%
16%
16%
40%
36%
12%
6%
15%
16%
35%
39%
0% 10% 20% 30% 40% 50%
Don't know
Trade Body•
Government
NHS
Professional Body
Regulator
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Host for System of Disclosure Mixed views on best way of hosting the system
Q4: Who do you think should host any system for declaring payments? Base: Those who strongly/agree that there should be a single, publicly searchable database (Q4) - Individuals – 651; Commercial Companies - 45
Individuals Commercial Companies
GMC recommended as
regulator by RCGP
Should HCPs play a role in
disclosure of payments?
48%
66%
76%
78%
82%
77%
27%
15%
14%
14%
11%
13%
24%
20%
11%
9%
8%
10%
Academy MRC
RCPE
RCP
BMA
RCGP
Total
REGISTER OF PAYMENTS – CONSULTATION SURVEY
HCP involvement Members of most HCP organisations are in favour; the Academy of MRC are less
positive
Q5: Do you agree or disagree that individual health care professionals should play a role in the disclosure of payments received from commercial organisations (e.g. submitting information or validating the information submitted by others), alongside the submission of the same information by industry? Base: Total - 1054
Agree/strongly Neutral/Don’t know
Disagree/strongly
(N=1054)
(N=87)
(N=561)
(N=61)
(N=538)
(N=29)
Those in the Academy and RCPE statistically less likely to agree vs. those in BMA, RCP and RCGP BMA and RCGP agree
Should disclosure apply to all
types of commercial life sciences
organisations?
90% 4% 5% Total
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Disclosure for all Life Sciences? Universal agreement that all types of company should be involved
Q6: Do you agree or disagree that disclosure of payments to health care professionals should apply to all types of commercial life sciences organisations (e.g. devices, diagnostics and bio-pharmaceutical industry) and not only the pharmaceutical industry? Base: Total - 1054
Agree/strongly Neutral/Don’t know
Disagree/strongly
No difference in views of different respondent type or those in different sectors
RCGP believes there should be a
definitive list of types of companies to
which disclosure applies
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Impact of Public Disclosure on Future Collaboration with Commercial Organisations Majority consider that there would be little detrimental effect
8%
70%
14%
8% Would be more likely to collaborate
Would have no effect on mycollaboration
Would be less likely to collaborate
Don't know •
Q8: What impact would the public disclosure of payments have on your relationship with commercial organisations? Base: All individuals - 964
Little difference according to respondent
type or level of current collaboration;
Psychiatrists tend to consider they would
be ‘more likely’ to collaborate (given
public disclosure of payments) than
Secondary Care doctors (12% vs. 6%)
Effect of public disclosure of payments on relationship with commercial organisations
REGISTER OF PAYMENTS – CONSULTATION SURVEY
Public Disclosure of Payments could reduce collaboration for 1 in 6 who currently
take part in paid activities
Current participation in paid
activities with commercial
organisations
14%
7%
4%
61%
73%
72%
9%
16%
16%
15%
5%
8% Currently participate
Have participated in the past
Have never participated
More likely Will have no effect
Less likely Don’t know
(N=264)
(N=465)
(N=236)
Effect of public disclosure on relationship with commercial
organisations – willingness to collaborate in paid activities:
Q7: How would you describe your current level of collaboration with commercial organisations?; Q8: What impact would the public disclosure of payments have on your relationship with commercial organisations? Base: All individuals - 964