Millions of euro in payments by drugs companies to doctors are taking place in secret because medics will not give consent for disclosure of the transactions.
While almost €3.9m in payments to named doctors was disclosed last year, the recipients of a further €2.7m could not be divulged.
Some 2,837 individual payments made during the year were disclosed with the recipients named, but at least 1,819 were not.
The payments make up part of the €29.4m that pharmaceutical firms gave to the health sector last year through donations and grants to hospitals, colleges, and patient groups; sponsorship of events, contributions to individual medics to cover the cost of attending seminars; and other fees to individuals for “service and consultancy”.
In total, 44 companies made €29.4m transfers of value in 2017, a similar figure to the €30.1m made in 2016 and the €27.2m in 2015
Legislation to make disclosure mandatory and establish a publicly searchable register of payments was proposed by Fianna Fáil TD Billy Kelleher almost two years ago and is backed in principle by Health Minister Simon Harris. However, its progress has stalled.
Industry body, the Irish Pharmaceutical Healthcare Association (IPHA), began a voluntary disclosure scheme in 2015 in response to growing concerns about possible conflicts of interest and the influence drugs firms might have on the prescribing decisions of doctors.
The IPHA had already banned its members from giving gifts to doctors the previous year and says it now only permits payments directly related to their work and research.
It collects and publishes details of payments or ‘transfers of value’ annually from 44 companies with Irish operations and says they fully support the move towards transparency.
It says it also encourages all medics to give their consent for inclusion but it can not oblige them to co-operate and can not disclose without consent because of data protection laws.
Hospitals, colleges, and patient groups do not have to give consent but individuals are asked to tick a box agreeing to disclosure when they accept a transfer of value.
IPHA spokesman Philip Hannon said the disclosure rate was 58.3% last year, up from 50% in 2016.
IPHA would like to see a 100% disclosure rate and has encouraged healthcare practitioners to do so,” he said.
Cancer specialist and former senator John Crown said it is the norm in Europe for drugs companies to cover registration fees and travel and accommodation costs for attendees at medical seminars as hospitals generally do not reimburse staff.
Prof Crown said he had no issue placing such payments on public record.
“I personally disclose and I would be supportive of legislation to make disclosure universal,” he said.
Mr Kelleher’s bill, the Medical Practitioners (Amendment) Bill, was considered by the select health committee, which submitted a report to the Dáil last year suggesting it did not go far enough and might need to be extended to nurses, pharmacists, and other health professionals.
It also raised practical issues such as which body would administer a register and if a complaints mechanism might have to be established.
Overall the committee was supportive, however, and said the move could result in doctors prescribing fewer expensive branded drugs where cheaper generic alternatives were available.
It is envisaged that the bill would lead to reduced public expenditure on pharmaceuticals,” it said.
The Department of Health said: “The minister agrees with the general objectives of the bill, but the current draft will require significant amendments to optimise its effectiveness.”
“For full transparency, the legislation should apply to all in receipt of such gifts or funding.
“Work on amending this bill has not yet commenced.”