Pharmaceutical industry self-regulation and non-transparency: country and company level analysis of payments to healthcare professionals in seven European countries

Shai Mulinari, Luc Martinon, Pierre-Alain Jachiet, Piotr Ozieranski

Research output: Contribution to journalArticlepeer-review

26 Citations (SciVal)


The European pharmaceutical industry uses the alleged efficacy of self-regulation to question the need for transparency laws similar to the US Physician Payment Sunshine Act. We conducted a comparative analysis of 20 large companies' payment disclosures in seven European countries in 2017-2019. The data was extracted as part of, a novel transparency project that scrapes and integrates publicly available databases and disclosures. Our analysis of EUR 735 million showed marked differences in country payment patterns. For example, payment totals per registered doctor were substantially larger in Spain and lowest in Sweden. There were significant country and company differences in individualized data completeness. Only 19% of totals were reported with recipient names in Germany, compared to Ireland (59%), the United Kingdom (60%), Italy (67%), Switzerland (73%), Sweden (79%) and Spain (100%), with little or no improvement over time. Payment data in Spain was particularly difficult to extract. Thus, in no country did self-regulation generate comprehensive individualized data allowing for building an accurate picture of financial relationships between the industry and healthcare professionals. We conclude that the cultures and policies of countries and companies create structural problems of data inaccessibility and incompleteness within the self-regulatory framework. Therefore, this study supports calls for a Europe-wide "Sunshine Act" to achieve real transparency of drug company payments.

Original languageEnglish
Pages (from-to)915-922
Number of pages8
JournalHealth Policy
Issue number7
Early online date4 May 2021
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
SM's and PO's work were supported by grants from The Swedish Research Council for Health, Working Life and Welfare (FORTE), no. 2016-00875, and The Swedish Research Council (VR), no. 2020-01822, both awarded to SM and PO.

Funding Information:
SM's partner is employed by PRA Health Sciences, a global Contract Research Organization whose costumers include many pharmaceutical companies. LM and PAJ are members of Euros for Docs, a non-profit organization registered in France that seeks to promote transparency of drug company funding in the healthcare sector by making payment data accessible and complete across Europe. PAJ is employed by Haute Autorité de Santé, the French independent health technology assessment organisation. PO's PhD student was supported by a grant from Sigma Pharmaceuticals, a UK pharmacy wholesaler and distributor (not a pharmaceutical company). The PhD work funded by Sigma Pharmaceuticals is unrelated to the subject of this paper.

Publisher Copyright:
© 2021 The Authors

ASJC Scopus subject areas

  • Health Policy


Dive into the research topics of 'Pharmaceutical industry self-regulation and non-transparency: country and company level analysis of payments to healthcare professionals in seven European countries'. Together they form a unique fingerprint.

Cite this