Managing conflicts of interest in the NHS
We are living through a golden age of drug discovery. Newspaper front pages tell us weekly of the scientific breakthroughs being made in cancer, cardiovascular disease and HIV. The pharmaceutical industry is incredibly proud of our role in pushing forward these advances to benefit the lives of patients across the UK.
The story of discovering and developing a new drug from bench to bedside is an extraordinary one. On average, it takes over 12 years and costs over £1 billion to develop a new medicine. And crucial to this process is the role of doctors, nurses and other NHS professionals – working with industry – to deliver these breakthroughs.
That’s why I’m proud of these relationships and why I feel passionately that they are critical to the success of the medical innovations of the future. But for these relationships to thrive, transparency about them is crucial.
The Association of the British Pharmaceutical Industry (ABPI) has done much to increase the transparency about the relationships between healthcare professionals and pharmaceutical companies. The ABPI Code of Practice sets the standard, clearly setting out what pharmaceutical companies can and cannot do when engaging with doctors, nurses and other health care professionals. Importantly, the Code makes it absolutely clear that joint working between pharmaceutical companies and NHS employees ‘must always benefit patients’. It covers everything from prohibiting companies from giving doctors note pads and pens, to ruling that only economy flights can be taken to overseas conferences.
This year the ABPI took transparency further by establishing ‘Disclosure UK’. For the first time, details of payments or benefits in kind made to health professionals and healthcare organisations in the UK were made available on a publicly accessible database. It outlines payments for services including speaking at and chairing meetings and training services. But the vast majority of payments relate to research and development activity – predominantly clinical trials. When Disclosure UK launched on 30 June, £229m of the £340m of payments disclosed were for research activities. I thank the majority of healthcare professionals and organisations who have disclosed their data. This helps to tell the story of the NHS being at the forefront of developing and launching new medicines.
It is because of this commitment to transparency that I was pleased to accept the invitation from Sir Malcolm Grant to sit on the ‘Task and Finish’ Group to look at conflicts of interest in the NHS.
The Group was set up to look at how to establish a common approach to managing any perceived conflicts of interest across the NHS. Of course, this is a much wider question than just the relationship the NHS has with the pharmaceutical industry. But I was pleased to be able to give a perspective from the industry and share what we have learnt about how to manage any conflicts of interest arising.
For the ABPI, it is absolutely critical that pharmaceutical companies can continue to work with doctors, nurses and other NHS staff to develop and deliver new medicines. Without the insights from those on the frontline of patient care, we lack the feedback on how medicines are working in practice.
And these relationships are critical for the NHS too. Indeed, under the NHS England Mandate, the NHS has an objective to support research, innovation and growth to ‘harness research and innovation to enable cost effective, affordable, transformative new treatments to reach patients more quickly’. The pharmaceutical industry can be at the heart of delivering this alongside the NHS. The recent announcement that the NHS has appointed its hundredth clinical entrepreneur as part of a programme supported by a range of pharmaceutical companies is proof that this is already happening.
The Task and Finish Group enabled some good discussion about how this collaboration can be fostered, whilst giving the public confidence in the nature of these relationships. The consultation response seeks to strike that important balance.
Getting this balance right will be crucial in allowing our golden age of drug discovery to continue.
Mike Thompson
Mike Thompson is Chief Executive of the Association of the British Pharmaceutical Industry.
Mike took up the position of CEO of the ABPI in March 2016, joining from GlaxoSmithKline where he was most recently senior vice president of global commercial strategy and platforms leading teams of experts in areas such as multi-channel, market research and analytics as well supporting colleagues in research and development to bring new medicines to launch.
During 20 years with GSK Mike spent seven years as the commercial strategy head for Europe and before that ten years in the UK company in a variety of senior sales and marketing roles.
A graduate of The Queen’s College, Oxford, Mike has worked across multiple sectors including food, drinks, toiletries and Government agencies. He joined Unilever as a trainee in 1981, leaving in 1995 as Marketing Director in the UK, to join GSK.
6 comments
Mr Thompson claims
The T&F Gp enabled … discussion about how this collaboration can be fostered, whilst giving the public confidence in the nature of these relationships.
Given
The group is led by Sir Malcolm Grant, Chair of NHSE and includes reps from BMJ, NICE, CQC, LGA and ABPI
BUT not one mention of P&Ps
How does he justify this claim?
Does the Chair share his great confidence?
A P&P presence?
NOT
Self declared Patient Leaders
VCS groups claiming to speak on behalf of P&P
CCG Lay NEDs, chosen and retained by the CCG, to speak on behalf of their disenfranchised, non-electorate
They carry no mandate from P&P
These are P&P delegates, chosen by, and responsible to, that public
Who
Require proof that Conflicts of Interest have been properly defined & will be eliminated
Will sit on the Scrutiny Committee/s as full members
Then, and only then, can P&P start to have confidence in links between a Service, and the Profit driven private sector
From the ABPI web site:
The Prescription Medicines Code of Practice Authority (PMCPA)
was established by
The Association of the British Pharmaceutical Industry (ABPI)
to operate
the ABPI Code of Practice for
the Pharmaceutical Industry
independently of the ABPI.
The PMCPA is a division of
the ABPI
which is a company limited by guarantee registered in England & Wales no 09826787, London SW1E 6QT.
Which in plain English is:
Big British (?) Pharma [BBP]
has set up its own wholly owned subsidiary –
Pharma’s Tame Watchdog [PTW]
to guard the profits and ‘Good name’ of its owner against any
Public & Patients [P&P], or other
Do Gooders [DG] or
Busy Bodies [BB]
who fancy themselves as a
Constant Gardener [J le C]
One might ask :
Sed quis custodiet ipsos custodes?
‘Getting this balance right will be crucial in allowing our golden age of drug discovery to continue.’ In order to achieve this rather bald statement, first and foremost is the public’s perception and understanding of the ‘operational mechanics’ will be put in place and monitored appropriately. For conflict of interest to work effectively there needs to three separate but distinct elements:
1. Legal implications for compliance with all the relevant statutes, policies and other related laws.
2. Standard Code of Ethics of which the profession must abide by.
3. Agreed and accepted good practice on how to handle conflicts of interest when then arise that are linked to points 1 and 2. These elements have not been raised in this advertising pitch.
Most important:
“3 Agreed and accepted good practice on how to handle conflicts of interest when then arise that are linked to points 1 and 2”
However, agreed by whom?
BMJ NICE CQC LGA and ABPI of course
But NOT
Self declared Patient Leaders
VCS groups claiming to speak on behalf of P&P
CCG Lay NEDs chosen and retained by the CCG, to speak for a disenfranchised, non-electorate
They carry no mandate from P&P
What WE are entitled to are real P&P delegates, chosen by, and responsible to us
They will:
Require proof that Conflicts of Interest have been properly defined & will be eliminated
Sit on the Scrutiny Committee/s as full members
Then, and only then, can P&P start to have confidence in links between an N H Service and the Profit driven private sector
“These elements have not been raised in this advertising pitch”
Yet another such! Indeed when one has pointed out some of the undeclared financial and business links in other pitches they’ve been censored out of existence
What excellent PR by Mr Thompson.
The headline figure is not stated. That 2/3rds of Pharma expenditure is on marketing and “education” and only 1/3rd on scientific development.
Transparency is only a means to an end in my opinion. The ABPI Register is meaningless without mandatory declarations. Worse than that it gives the illusion of transparency.
Pharma and Commerce has it on a plate with CME being required for Appraisal and Revalidation. My research for a Sunshine Act in Scotland has revealed the truly shocking SCALE of Pharma “education”. This is anything but “all in the past” as the ABPI are keen to keep saying!
The Scottish Public have been consulted and in MAJORITY ask that it is MANDATORY for all payments to be made public.
My view is that science and business need to be completely separate. Otherwise it is not science, which as Robert K Merton said should always be “disinterested”.
My conclusion: ZERO out of TEN for the ‘Task & Finish Group’
@Dr Peter J Gordon 23 September
“My conclusion: ZERO out of TEN for the ‘Task & Finish Group’”
But, you can’t possibly write that! The group is led by Sir Malcolm Grant, Chair of NHSE.
If your assessment is correct, that could imply that Sir Malcolm has slipped up in one of the most crucial areas of modern day healthcare, and might have to ‘consider his position’?
And where Could that Finish?