Pharmaceutical Industry Funding to Patient-Advocacy Organizations : A Cross-National Comparison of Disclosure Codes and Regulation

Transparency has become one of the primary themes in health care reform efforts in the United States and across the world. In the face of exorbitant drug prices, high levels of patient cost-sharing, and pharmaceutical expenditures that consume a growing proportion of public sector budgets, much attention has been drawn to the pharmaceutical industry. Congressional investigations, academic publications, and news articles have endeavored to reveal the extent of drug and device industry influence on health care actors. In response, several nations, including the United States, have passed legislation mandating disclosure of drug company payments to physicians. In the United States, there are currently no legal requirements for disclosure of pharmaceutical industry sponsorship to patient-advocacy organizations by either party to the transaction. An ongoing concern is that drug industry payments could interfere with the objectivity of patient-advocacy groups and may induce them to take public positions favorable to the drug industry but at odds with the interests of patients. This article provides a comparative analysis of industry codes of practice and regulation that govern relationships between pharmaceutical companies and patient-advocacy organizations in the United States, the United Kingdom, Germany, France, Australia and Canada, with an emphasis on disclosure policies for industry sponsorship. The article draws upon the practices of other nations and the Physician Payments Sunshine Act to make a case for an expansion of the Sunshine Act to patient-advocacy groups