THE Australian Medical Association is reviewing doctors’ relationships with industry after evidence showing an association between corporate funding and doctors’ prescribing behaviour, and revelations of undeclared financial relationships between doctors and pelvic mesh manufacturers.
AMA president Dr Michael Gannon said a five-year review of the position statement on medical practitioners’ relationships with industry would consider “evidence around this important issue”, including a series of studies showing even cheap industry-funded meals were associated with increased prescribing by doctors.
Confirmation of the 2012 review comes after Dr Gannon in August said the AMA’s marketing of a pelvic mesh device more than a decade ago as an “Australian medical design breakthrough”, despite women’s reports of complications in Western Australian public hospital trials from as early as 1989, was “a long way from our proudest hour”.
The Australian-invented device helped spark a global pelvic mesh scandal after it was sold and registered for use in America in 2001 to treat prolapse, despite no evidence supporting that use.
It also comes after the Australian and New Zealand College of Obstetricians and Gynaecologists in September failed to declare substantial funding from pelvic mesh manufacturers and marketers for more than a decade to a Senate inquiry investigating pelvic mesh.
The college denied being influenced by health industry funding, but has been criticised by health advocates and some senior obstetricians and gynaecologists for being largely silent for a decade about the risks faced by women from pelvic mesh devices, despite evidence of severe complications in some women.
Dr Gannon said the AMA’s ethics and medicolegal committee, on which he sits, released a position statement in 2012 which did not specifically state that industry marketing influences prescribing behaviour. New research showing clear associations would inform the current review.
“Doctors should be aware of this influence and ensure their professional judgement is not compromised by industry relationships,” he said.
“At its heart the current policy states that doctors’ relationships with industry are for the public benefit so long as they are appropriately managed to put patients’ interests first and to maintain public trust and confidence in the profession.
“The AMA believes it is imperative that doctors’ relationships with industry should be open and transparent, able to withstand public and professional scrutiny, meet public and professional standards and expectations and adhere to relevant legislative and regulatory requirements.”
It was important that “doctors and industry work collaboratively to improve the quality of, and access to, health care” but “it’s essential that doctors manage such relationships appropriately to avoid real and perceived conflicts of interest which can undermine public confidence and trust in the medical profession”, Dr Gannon said.
The doctor’s primary duty is to act in patients’ interests, not the interests of doctors or industry.”
The AMA advocates that the overriding principle guiding doctors' relationships with industry is the primacy of patient care. The doctor's primary duty is to act in patients' interests (not the interests of doctors or industry);
The AMA’s current position statement said it was “ethically acceptable for industry to support meetings that contribute to doctors’ education” but the funding should be “untied, fully disclosed, at arms’ length to the organisation of the meeting”.
In a statement to the Newcastle Herald in August, after confirming the AMA’s direct links with progression of the global pelvic mesh scandal, Dr Gannon said that “to call this a tragedy is not overstating it at all”.