From June 2016, we will publicly disclose information on payments and transfers of value that we make to doctors and other healthcare professionals (HCPs) in Europe as part of an initiative by the European Federation of Pharmaceutical Industries and Associations (EFPIA).
As part of our decade long journey to increase the transparency of clinical research and interactions with healthcare professionals, we continue to make changes, such as stopping payments to doctors to speak about our prescription medicines, refreshing our approach to medical education and putting an end to compensation for sales representatives based on numbers of prescriptions generated.
We have already seen the benefits of these changes in some countries. While our new ways of working with HCPs came into effect across the globe on 1 January 2016, some European countries had already stopped paying for external HCP speakers and some have already published payments made to HCPs, in line with local government regulation or industry association codes. This includes the Netherlands, Denmark and Norway.
Pioneering transparency in the Netherlands
In 2012, GSK Netherlands became one of the first countries to publish information about payments by pharmaceutical companies to HCPs through a transparency register. This national initiative was supported by an agreement between the government and 15 organisations, including the pharmaceutical industry and independent medical associations.
Neale Belson, General Manager, GSK Netherlands, said: “The transparency register is definitely seen as a success by all involved. The process was valued highly because it was carried out with the joint co-operation of the industry and medical professionals”.
The Netherlands register is seen as a model of good practice by other industries, such as veterinary medicine and medical devices. “It has triggered a new kind of thinking about how to collaborate”, added Neale. “A logical next step is to develop a more multi-channel approach to working with HCPs. We’re putting this in place now in the Netherlands with new digital and real-time applications aimed at improving the delivery of medical information to our customers”, he continued.
Going beyond transparency in Denmark
As part of a government-led initiative, doctors in Denmark have been disclosing payments received from the pharmaceutical industry since November 2014. Henrik Kastoft, Head of Communications, GSK Denmark, explained that any concerns about disclosure preventing doctors from collaborating with industry partners soon disappeared.
“We want to work with those doctors whose priority is their patients, and the trust that patients have in decisions made about their care”, he said. “This group of doctors has reacted positively to disclosure, and it has only strengthened our relationship with them by removing doubts about possible conflicts of interest”, he continued.
Stopping speaker payments to doctors has also had a positive impact. Henrik noted: “The head of a Danish medical association publicly described our initiative as “ground-breaking”. It has been reported on very positively in several business and medical media articles, with in-depth interviews with our medical advisors”.
These initiatives have encouraged us to think and act more innovatively.
“Instead of an external healthcare professional, we invited a Professor in Ethics to speak at GSK Vaccines meetings in October and November”, continued Henrik. “We had 70 HCPs attend each meeting, far exceeding the expected audience of 15-20 people”, he said.
Embracing new opportunities in Norway
When GSK Norway stopped making speaker payments to doctors in 2015, one of the largest changes was the shift towards maximising internal expertise. “There are several benefits to making more use of our internal resources”, said Line Storesund Rondan, Head of External Affairs and Market Access. “Instead of paying experts to speak on our behalf, internal teams – medical and commercial – have had the opportunity to demonstrate their knowledge and skills in new ways”, she said.
There has been positive feedback in using internal speakers. “In general, the feedback from HCPs at events where there has been an internal GSK expert speaking has been encouraging,” Line added.
Some HCPs initially perceived external HCPs to have a higher credibility. However, they are increasingly seeing GSK speakers as experts not only on our products, but also the broader disease area.
In addition, digital technologies, such as webinars, are proving a popular for HCPs to receive the information they need when and how they want it. “These are especially relevant for a country like Norway, where many HCPs are geographically distant from major centres”, noted Line.
Insights so far
What can we learn from the experiences of the Netherlands, Denmark and Norway in transitioning to new ways of working with HCPs?
Firstly, collaborate. As the Netherlands experience demonstrates, transparency does not prevent cooperation and collaboration with HCPs. Productive, open, working partnerships between the pharmaceutical industry and the medical community remain at the heart of transparency initiatives. They are also fundamental to scientific and medical innovation.
Secondly, innovate. Henrik confirmed, “We learnt it’s not necessary to have doctors external to GSK speak at our meetings to make them interesting to other HCPs. Finding an alternative method, such as a debate led by an ethics professor, has helped make our meetings more innovative, engaging and popular.”
Thirdly, communicate. In Norway, it has been important to communicate ‘why’ and ‘how’ as well as ‘what’. “The initial reaction among HCPs was varied. This was because some perceived changes as a GSK cost-cutting exercise”, explained Line. “This has improved over time as we explain the changes are not about ‘not’ working with doctors, but working in a different way that is ultimately in the best interests of patients. Patient trust is behind our drive to being more transparent. Without it we simply cannot succeed as a science-led healthcare company.