New Health Ministry Report Warns: Drug Company Donations Raise Conflict Concerns

The national health insurance law requires health-related donations to be reported; donors are not required to detail the sums they contributed or the purpose.

A Health Ministry report on drug companies’ donations to hundreds of medical institutions and organizations raises concerns about conflicts of interests. The ties between the companies and the institutions could affect drug prescriptions, and could also influence recommendations made by the committee in charge of adding new drugs to the “health basket” of state-subsidized medical services.

“The larger a drug company’s sales are, the stronger its ties with medical institutions such as health maintenance organizations and the greater the company’s ability to donate to more institutions,” a drug company official said.

Drugs - AP - January 10 2011

All medical institutions, including hospitals, HMOs and the Health Ministry, received money from drug companies, said the report, which listed contributions in 2010.

MSD Israel, a subsidiary of Merck, donated money to 65 medical institutions and groups, the report said. MSD markets Gardasil vaccine against cervical cancer, the Januvia treatment for diabetes, Posallan for arthritis, Ezetrol to reduce bad cholesterol in the blood, and RotaTeq vaccine for babies, which last year won a Health Ministry tender to become the rota virus vaccine administered in well-baby clinics.

Roche and Abbott Laboratories donated to 56 medical institutions each, Teva to 53, Schering-Plough to 49, Ferring to 46, Bayer to 42, Neopharm and Neopharm Medical Equipment to 42 and Sanofi-Aventis to 39.

Most of the donations are presumably intended to advance research, help finance medical periodicals and set up booths at medical conferences.

Nevertheless, the report raises concerns about the possible ties being formed between the HMOs and the donor companies, especially since the HMOs’ representatives are members of the committee that recommends new additions to the health basket.

These concerns are strengthened by the fact that HMOs sometimes instruct doctors and pharmacies to prescribe specific drugs when several different treatments are available.

Clalit HMO received contributions from 11 drug companies, Maccabi from eight, Leumit from four and Meuhedet from three. The Health Ministry received one donation from Schering-Plough in 2010.

TheMarker reported last month that the leading companies in drug sales to HMOs in 2010 were Roche ‏(NIS 534.1 million‏), Teva ‏(NIS 450.5 million‏), Novartis ‏(NIS 373.8 million‏), MSD ‏(NIS 352 million‏) and Pfizer ‏(NIS 313 million‏).

The Health Ministry report also exposed the ties between patients’ organizations, which lobby to get various drugs added to the health basket every year, and the drug companies that support them.

Teva donated to 36 patient organizations’ in 2010. Pfizer donated to 18 and MSD to 17.

The national health insurance law requires health-related donations to be reported. But this provision, which came into effect three years ago, applies only to the donors, not the recipients. Moreover, donors are not required to detail the sums they contributed or the purpose of the gifts.

“We welcome any process that would increase transparency in the ties between drug companies and doctors,” said Prof. Avinoam Reches, who chairs the IMA’s ethics committee.