But nurses and their employers have defended the pharmaceutical sponsorship, saying companies do not exert influence and it creates opportunities for professional development.
They say this in turn benefits patients. “There’s no requirement of any sort, there’s no feeling that I’m beholden to anybody,” said a senior nurse among the most courted by companies.
Researchers are concerned the support is aimed at increasing prescriptions and will drive up the costs of medication. “These companies currently market some of the highest-cost drugs on the market for diseases such as cancer and hepatitis C,” said Dr Quinn Grundy, a nurse and researcher at the University of Sydney.
Dr Grundy’s research last week revealed companies had spent $12.5 million on nurses over four years and that even though most can’t prescribe, nurses attended twice as many sponsored medical events as doctors.
A Fairfax Media analysis of transparency reports to industry group Medicines Australia shows 27 pharmaceutical companies disclosed spending more than $650,000 across 663 nurses in the six months to April 30. But the actual amounts could be much higher as 45 per cent of total contributions to health professionals were not identified in the data.
About $565,000 of that was used to send nurses to educational meetings and conferences and a further $73,000 paid for the services of nurses who sit on their advisory boards.
For example Bristol-Myers Squibb paid $46,703 for about 70 nurses from around Australia to attend an educational meeting in March at the luxurious Langham Hotel on Melbourne’s Southbank.
The purpose of the meeting was to learn about its hepatitis C drug Daklinza, which had just been added to the pharmaceutical benefits scheme.
Overall, Bristol-Myers Squibb spent at least $120,000 on nurses over the period, the most amount disclosed of all companies, followed by Novartis ($82,642), Gilead ($72,899), and Pfizer ($53,767).
A Bristol-Myers Squibb spokeswoman said the company had a responsibility to make sure their drugs were used safely.
“Our support for educating nurses about our medicines contributes to the quality use of those medicines and to improving patient care and health outcomes,” she said.
The three nurses who pharmaceutical companies spent the most on all operate in specialty fields, two in hepatology, which concerns illness of the liver and related organs.
The nurses are regarded highly and their employers have no commercial dealings with the companies involved. Each employer expressed full support for the nurses, and their interactions with companies.
Over the six months, three companies made payments totalling $15,427 to cover the travel and advisory fees of nurse Sherryne Warner, a consultant with the Monash Medical Centre, and research manager at Monash University’s Liver/Gut Inflammation and Fibrosis Research Group. She manages clinical trials.
Ms Warner sits on advisory boards for several companies, which involves giving feedback on what level of education patients and doctors need about particular drugs and areas that could be improved, she said.
“I don’t have any ability to be able to influence what drugs my patients actually get or to influence the consultants that I work with to write those prescriptions,” Ms Warner said.
Ms Warner said she did not know why drug companies paid for nurses’ travel to conferences, which included$10,000 Bristol-Myers Squibb spent to send her to a five-day International Liver Congress in Barcelona, but said nurses cannot afford to go to educational meetings otherwise.
“In Australian within the field that I work in we abide by the Australian guidelines which come out of a lot of the clinical trials, but we also work to many of the international standards and guidelines and that’s where they’re also presented and developed,” she said.
Companies also disclosed spending a combined $14,651 on Tracey Jones, a nurse practitioner for hepatitis C at John Hunter Hospital in NSW, and $14,411 on Michael Brown, a nurse consultant at Royal Melbourne Hospital.
John Hunter Hospital general manager Debbie Bradley said as long as staff abided by NSW Health and the hospital’s policies, and there are no conflicts, the hospital was “supportive of staff participating in these types of arrangements”.
She said Ms Jones provided advice widely as one of the most senior clinical nurses in her field and “sponsorship arrangements with pharmaceutical companies offer opportunities for our staff to receive ongoing training and education.”
Pfizer paid $13,011 for Mr Brown to attend a conference at a medical centre in Jerusalem that specialises in a rare condition, a trip his employer supported. “Gaucher disease is an ultra-rare condition, and opportunities to learn from staff at an experienced treatment centre are uncommon and extremely valuable for improving patient care,”an RMH spokeswoman said.
Dr Grundy said sponsorship of nurses needed to be scrutinised as studies had shown these practices with doctors was linked to rising prices.
“Sponsorship of events and payments to doctors and physicians are associated with increased prescription of promoted drugs,” she said. “Heavily promoted new drugs tend to be higher cost and have less of a track record for safety than drugs already on the market, which can drive up healthcare costs and create threats to public health.”