June 7, 2016
Fighting corruption in the pharma sector – why we all have a role to play
Corruption within the pharmaceutical and healthcare sectors is a matter of life and death. It has a corrosive impact on health, negatively impacting public health budgets, the price of health services and medicines, and ultimately the quality of care dispensed.
Reports estimate that as much as 6% of annual global health expenditure is lost to corruption and errors. While 6% may look like a small figure, it is worth keeping in mind that it represents over US$ 300 billion (World Health Organisation, The World Health Report (2010b), p.61). The pharmaceutical sector accounts for a significant portion of health budgets globally: almost one fifth of the entire healthcare budget across OECD countries is spent on medicines. Despite this, efforts to measure the true scale of the problem and respond effectively are lacking.
A new publication from Transparency International Pharmaceutical & Healthcare Programme, Corruption in the pharmaceutical sector – Diagnosing the challenges, is premised on the belief that preventing abuse and reducing corruption is key to making more efficient use of existing resources with the ultimate goal of improving the global quality of healthcare. Given the significant size and role of the pharmaceutical sector in global healthcare, this paper focuses on analysing the private and public sector aspects of the sector to analyse its vulnerabilities to corruption and the related inefficiencies and impact on healthcare outcomes.
The paper’s main findings include:
- Corrupt practices include paying doctors to participate in surveys of medicines they have never actually prescribed, and companies ghost-writing clinical trial articles that are presented as the work of eminent researchers. This practice – identified particularly in industry-led trials – can increase the prestige of the findings, while researchers improve their reputation.
- Bribery and corruption, also allow some companies to get round manufacturing regulations, helping to create a situation where about a quarter of medicines consumed in low and middle-income countries are falsified or sub-standard.
- Pharmaceutical companies can unduly influence national political systems through their large spending power – thereby funding candidates that support their position on key issues.
- Pharmaceutical companies can also buy a positive but misleading gloss on trials of a drug’s safety and effectiveness. Vast sums are spent on influencing doctors and this sometimes involves persuading them to prescribe expensive drugs that were no better than cheaper alternatives.
- In some countries, a pharmaceutical company can use representatives to collect data on the safety and efficacy of its medicines from doctors who did not even prescribe the medicines being studied, in return for some kind of compensation.
- In countries lacking good governance, bribery and corruption could also be used to get around medicine manufacturing standards.
In order to move forward, the paper identifies the following areas of action:
- Establishing a leadership committed to addressing corruption: All actors must display a genuine commitment to tackling corruption. Those within the pharmaceutical industry committed to pioneering change – and TI unequivocally acknowledges they exist – will play a decisive role. In fact, we are currently developing a set of anti-corruption principles for Latin American pharmaceutical companies in collaboration with FIFARMA (Latin American Federation of the Pharmaceutical Industry). We will continue to encourage the industry to use its unique position to engage with governments and make the economic argument for corruption’s negative effect on business. Crucially, cooperation through multi-stakeholder alliances – bringing together governments, the pharmaceutical industry, global institutions and civil society organisations – is a key element of success.
- Adopting technology throughout the pharmaceutical value chain – to reduce the opportunity for corruption to promote transparency and accountability, thereby reducing the instances of meetings behind closed doors.
- Ensuring accountability through increased monitoring, enforcement and sanctions – governments must implement processes to track activities, publish data, and ensure that all regulation and legislation are properly implemented to ensure that corrupt activities are investigated and punished.
Transparency International’s Pharmaceuticals & Healthcare Programme recognises and encourages any positive steps towards limiting the risk of corruption and strongly believes collaboration with industry is a vital part of promoting change.
Preventing corruption in any sector requires the active support of all with a vested interest in that given industry. In the pharma sector it is no different and there are plenty of individuals at all levels who want to see real change, for whose support we are grateful. For others our message may not be easy to take but pointing out systematic weaknesses is a vital part of improving systems. With thorough research and full engagement, this is the aim we pursue and we call on others to join the growing ranks of industry insiders who understand the corrosive nature of corruption.
Author: Sophie Peresson – Programme Director, Transparency International’s Pharmaceuticals & Healthcare Programme
Photo: Flickr / Derek Gavey.