1. The pharmaceutical industry spends millions each year promoting their drugs and developing relationships with doctors, which some argue can introduce conflicts of interest when doctors choose which drugs to prescribe for patients. 2. Studies have found that financial relationships between doctors and pharmaceutical companies, such as receiving free meals, can influence doctors to prescribe more of the promoted drugs. 3. Some countries and US states have implemented "sunshine laws" that require transparency around financial relationships between doctors and pharmaceutical companies in order to reduce potential influence on prescribing and allow more informed patient choice.

1. 1.The pharmaceutical industry
2.Promotion or
conflict of interest?
When we are ill we expect our doctor to prescribe the
medicine which is best for us. When prescribing drugs, doctors
often choose between similar medications made by large,
international, drugs manufacturers.
Every year pharmaceutical companies spend €millions
promoting their products and developing relationships with
medical professionals.
Examples of payments to doctors by pharmaceutical companies
Total payments made
by pharmaceutical
companies to
healthcare professionals
and organisations
by country
Source: europe.businesschief.com
Source: www.civio.es, ABPI, INFARMA, The Guardian
PAYMENTS FOR
CONSULTATION SERVICES
PAYMENTS TO SIT ON
ADVISORY BOARDS
REMUNERATION FOR
CONDUCTING RESEARCH
FREE GIFTS
AND MEALS
CONFERENCE TRAVEL AND
ACCOMMODATION EXPENSES
SPEAKER FEES
Biggest pharma companies in
Europe by revenue (2016)
Shedding Light:
why we need transparency
in healthcare / pharma relationships
$56.3bnBAYER
ROCHE
NOVARTIS
SANOFI
GLAXOSMITHKLINE
$53.48bn
$48.518bn
$40.72bn
$36.8bn
2016
2016
2016
2016
2016
2015
520
million €
148,3
million €
66,83
million €
181
million €
109
million €
104
million €
UK
BELGIUM
POLAND
SPAINGERMANY
AUSTRIA

2. Source: Fickweiler F, BMJ Open, 2017), DeJong BA (JAMA, 2016), Lieb K (PlosOne, 2014)
4.Promoting transparency
through sunshine laws
Gifts, drug samples
Key Opinion Leaders
Conference travel
Interactions with sales representatives
Honoraria
Free meals
Type of benefit
3. Do financial relationships affect prescribing?
Many psychiatrists acknowledge the pressure of
promotion by the pharmaceutical industry.
There is even evidence to suggest financial
relationships encourage overprescribing. One
study found doctors receiving free meals as part of
pharmaceutical industry promotions were 118% more
likely to prescribe the drug being promoted.
The pharmaceutical industry has self-regulated since 2014
through a voluntary code produced by the European
Federation of Pharmaceutical Industry Associations (it
covers 34 countries in Europe).
The data it publishes is difficult to access and does not
cover all doctors. In Austria in 2015, for example, only 22%
of doctors disclosed information about potential conflicts
of interest (Source: EFPIA, Ludwig Boltzmann Institute).
POLAND
CZECH
REPUBLIC
UNITED
KINGDOM
AUSTRIA
FRANCE
ROMANIA
BULGARIA
UKRAINE
ICELAND
SERBIA
GREECE
SPAIN
PORTUGAL
GERMANY
SWEDEN
FINLAND
ITALY
HUNGARY
SLOVAKIA
NETHERLANDS
BELGIUM
LITHUANIA
LATVIA
ESTONIA
IRELAND
CROATIA
SLOVENIA
SWITZERLAND
DENMARK
MALTA
Cyprus
LUXEMBURG
AUSTRIA
NORWAY
Researchers in the US compared Massachusetts, which
has a sunshine law, with neighbouring states without
sunshine laws. They found doctors in Massachusetts were
considerably less likely to prescribe antidepressant and
antipsychotic drugs.
Improve transparency around drug promotion
and pharmaceutical-doctor relationships.
Dissuade healthcare professionals from entering
into inappropriate relationships that could
negatively affect clinical practice.
Greater transparency allows patients to make
more informed decisions about their treatment.
More rational prescribing.
Why implement sunshine laws?
Irrational prescribing
Associated level of influence
Countries with
sunshine laws
To promote transparency some European states
have enacted sunshine laws - regulations that
oblige doctors and pharmaceutical companies to
disclose their financial relationships.
The work of Mental Health Europe is supported by the European Commission
through the Rights, Equality and Citizenship Programme. This infographic is the sole
responsibility of Mental Health Europe and can in no way be taken to reflect the views
of the European Commission.
Source: University of Michigan, Sinha MS (Am J Bioeth, 2017)
Branded Generic
Antidepressants 54% 45%
Antipsychotics 41% 40%
Significant increase in prescribing
Higher prescribing
Sunshine law
/ regulation
Transparency
/ Anticorruption law
No law
/ No information
Prescription rates in Massachusetts
compared to neighbouring states without
Sunshine Law
How sunshine laws
affect prescribing