The bucks start...

Doctors involved in assessing which drugs should be prescribed to NHS patients are receiving up to £100,000 per year from pharmaceutical companies. A new database reveals that individual medics are receiving tens of thousands of pounds in consultancy fees from the pharmaceutical industry while recommending products to patients. At the same time NHS officials involved in assessing which drugs should be prescribed to patients have been earning up to £20,000 from firms simultaneously marketing their products to the health service. However, tens of millions of pounds worth of payments to doctors and officials were not individually declared because the recipients refused to be named. The disclosures, based on figures in a new database published by the Association of the British Pharmaceutical Industry (ABPI), come after a series of Telegraph investigations have exposed the practice of NHS staff involved in prescribing work taking lucrative advisory fees from drugs firms.

It's the people who are still hiding information, from their patients and colleagues, that are particularly concerningBen Goldacre

The pharmaceutical industry says firms need the expertise of doctors, nurses and officials to help “bring the right medicine to the right patient at the right time”.

But the practice has also raised concerns about the potential for conflicts of interest between an individual’s commercial and NHS work.

The ABPI yesterday published a searchable database which shows a breakdown of payments from drugs firms to individual doctors, nurses, pharmacists and NHS officials. It described the publication as “a milestone moment for transparency in our industry”. According to the declared payments, the highest individual earner of fees and expenses from drugs companies last year was Ian Pavord, a respiratory medicine specialist at the Oxford University Hospitals Trust, who received £98,702.92. Brian Lipworth , a respiratory specialist at the University of Dundee, who works at NHS Tayside, received £96,647 in fees and expenses from Teva UK. Last night he admitted that he would routinely provide advice on their products in his role advising the formulary committee of the hospital where he works, given the wide range of drugs they produce, but insisted his outside work was always fully declared.  Prof Lipworth said he carried out work for some other firms, which had not been declared in the database, although his work for Teva represented the vast majority.

The database also showed that Omar Ali, formerly an official at Surrey & Sussex Healthcare Trust and exposed in a Telegraph investigation last year, received more than £20,000 in consultancy fees from drugs firms.

In total, £46m was paid out to medics and officials in “fees for service and consultancy” and related expenses in 2015. However, the industry body admitted that the payments making up around 52 per cent of this total were not individually included in the database because the recipients had refused to be named. The Telegraph reported on Wednesday how the identities of hundreds of individuals are being kept secret because doctors and officials are exercising their rights under the Data Protection Act to be anonymous.  In an exceptional case, GlaxoSmithKline is now refusing to work with those who decline to be included, meaning almost all of its payments were declared. Ben Goldacre, lead academic at the Evidence-Based Medicine Data Lab at Oxford University, which analysed the figures, said: “A financial conflict of interest does not necessarily mean that somebody is up to no good, but it does mean there are risks, and that they may be biased. That's why clearly declaring your conflicts matters, so that we can all judge for ourselves.” Dr Goldacre pointed out that the individuals included in the database were those who have “done the right thing” by “choosing to be transparent.” "It's the people who are still hiding information, from their patients and colleagues, that are particularly concerning,” he said. Prof Pavord could not be reached for comment.

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