The ESHLSG has published the results of the recent consultation in to the public disclosure of payments to health professionals.

1. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Prepared for: Ethical Standards in Health & Life Sciences Group
By: Jane Fligelstone – The Consortium and Nicky Taylor – Taylor McKenzie

2. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Objectives of the 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
NB: This consultation has been funded by the ABPI.

3. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Methodology
Quantitative
Online Survey
Timings
1055 responses
Survey live
Including 2 not completed online –
BMA and RCGP
28th January – July 5th 2013

4. 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
Commercial Companies
111
64
Healthcare Organisations (large)
8*
Healthcare Organisations (small)
3
* Includes two
questionnaires not done
online, not included in
quantitative analysis

5. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sample of Healthcare Organisations
Healthcare Organisations (large)
•
Royal Society of General Practitioners *
•
Royal College of Physicians
•
British Pharmacological Society
•
Guild of Healthcare Pharmacists
•
* Includes two
questionnaires not done
online, not included in
quantitative analysis
British Medical Association *
•
6
College of Optometrists
Private Healthcare Organisations (large)
•
BUPA Health and Wellbeing
•
AXA PPP Healthcare
2

6. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sample of Healthcare Organisations
Healthcare Organisations (small)
•
Bedfordshire Clinical Commissioning Group
•
2
Heathway Medical Centre
Private Healthcare Organisations (small)
•
HSC Innovations
1

7. 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
•
Healthcare Manager
11
2
‘Other’ Individuals (not coded):
•
Academic / Research in Medicine
•
Retired
•
Consultant in Pharmaceutical Sector
86

8. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Sectors of Commercial Organisations
Commercial Organisations
14%
8%
47%
31%
Devices
Pharmaceutical
What sector does your organisation/company belong to? N=64
Bio-Pharma
Other

9. 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

10. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Membership of Individuals in Sample
Individual membership (top 6 organisations)
BMA
59%
Royal College of Physicians
56%
Royal College of Psychiatrists
20%
The Royal Society of Medicine
16%
Faculty of Pharmaceutical Medicine
12%
RCGP
9%
0%
Base: 955 Individuals
20%
40%
60%

11. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Statistical Analysis
• 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

12. Results
REGISTER OF PAYMENTS – CONSULTATION SURVEY

13. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Scope of Consultation
Issue of
Single,
Transparency
CHALLENGES
Searchable
and Public
Database
FACING PSME
Declaration
Host for
System
HCP
Involvement
Whether
applicable to
all Life
Science
Companies
Effect on
Collaboration

14. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Transparency of Payments
Almost universal agreement that payments should be transparent
Agree/strongly
Should payments from
commercial organisations to
individually named health care
professionals be transparent?
Total
Neutral/Don’t know
89%
Disagree/strongly
3%
7%
No difference in views of different respondent type
BMA and RCGP agree
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

15. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Public Declaration
Widespread agreement that payments should be publicly declared
Agree/strongly
Should payments from
commercial organisations to
individually named health care
professionals be publicly
declared?
Total
Neutral/Don’t know
77%
Disagree/strongly
9%
15%
No difference in views of different respondent type
BMA and RCGP agree
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

16. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Single, Public Database
Widespread agreement that disclosure should involve central, public database
Agree/strongly
Should system of disclosure take
form of single, publicly
searchable, central database?
Total
Neutral/Don’t know
Disagree/strongly
79%
17%
4%
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
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

17. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Host for System of Disclosure
Mixed views on best way of hosting the system
Commercial Companies
Individuals
39%
36%
Regulator
Who should host any system for
declaring payments?
35%
Professional Body
NHS
16%
16%
Government
40%
15%
16%
Trade Body•
Don't know
6%
40%
9%
0%
10%
12%
20%
GMC recommended as
30%
40%
50%
regulator by RCGP
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

18. REGISTER OF PAYMENTS – CONSULTATION SURVEY
HCP involvement
Members of most HCP organisations are in favour; the Academy of MRC are less
positive
Neutral/Don’t know
Disagree/strongly
Agree/strongly
Total
Should HCPs play a role in
disclosure of payments?
77%
RCGP
82%
BMA
11% 8%
78%
RCP
76%
RCPE
Academy MRC
BMA and RCGP agree
13% 10%
14%
48%
15%
27%
(N=87)
9%
(N=561)
11%
14%
66%
(N=1054)
(N=538)
20%
24%
(N=61)
(N=29)
Those in the Academy and RCPE statistically less likely to agree vs. those in BMA, RCP and RCGP
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

19. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Disclosure for all Life Sciences?
Universal agreement that all types of company should be involved
Agree/strongly
Should disclosure apply to all
types of commercial life sciences
organisations?
Total
Neutral/Don’t know
90%
Disagree/strongly
4%
5%
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
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

20. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Impact of Public Disclosure on Future Collaboration
with Commercial Organisations
Majority consider that there would be little detrimental effect
Effect of public disclosure of payments on relationship with commercial organisations
Would be more likely to collaborate
Would have no effect on my
collaboration
8% 8%
14%
Would be less likely to collaborate
Don't know •
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%)
70%
Q8: What impact would the public disclosure of payments have on your relationship with commercial organisations? Base: All individuals - 964

21. REGISTER OF PAYMENTS – CONSULTATION SURVEY
Public Disclosure of Payments could reduce collaboration for 1 in 6 who currently
take part in paid activities
Effect of public disclosure on relationship with commercial
organisations – willingness to collaborate in paid activities:
More likely
Currently
participate
Current participation in paid
activities with commercial
organisations
Have
participated in
the past
Have never
participated
4%
7%
14%
Will have no effect
72%
16%
73%
61%
Don’t know
Less likely
8%
16%
9%
15%
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
5%
(N=264)
(N=465)
(N=236)