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Research led by the University of Toronto’s Lawrence Bloomberg Faculty of Nursing is shedding light on the scale of pharmaceutical industry-sponsored events that target health professionals responsible for prescribing medications.

Promotional events attended by prescribers such as physicians and nurse practitioners are a key component of marketing campaigns for new drugs and devices. But there is little transparency around their scope and extent.

In a bid to increase transparency on industry-prescriber interactions, researchers led by Assistant Professor examined data from the , a public database of payments made by drug and medical device companies to medical professionals.

Their study, , found that there were over 1.1 million industry-sponsored events in the U.S., one of the world’s biggest pharmaceutical markets, in 2022 alone. The top 10 products – based on number of sponsored dinner events – were the focus of over 16,000 dinners sponsored by seven companies.

“Identifying over one million of these events in one year alone – and their tendency to be for specific products – should give us pause and indicate that we need to understand the prevalence of these events from a systems perspective, considering their impact on prescribing practices,” says Grundy, who is also the director of the World Health Organization (WHO) Collaborating Centre in Governance, Accountability, and Transparency in the Pharmaceutical Sector.

Grundy notes that there is already a large body of evidence on the relationship between payments and physician prescribing outcomes. Receipt of industry payments, including low-value payments for food and beverage, is often associated with physicians prescribing higher quantities of promoted and higher-cost drugs, such as brand name drugs over generics.

The Open Payments database was established under the Affordable Care Act in 2012 in the hopes of creating greater transparency around the relationships between clinicians and the pharmaceutical and medical device industries.

Using the database, researchers were able to examine records of payments from pharmaceutical and device companies to clinicians for food and beverage and to link these across matching variables to identify – and quantify – in-person sponsored events for specific products. Excluding conferences and virtual events, the numbers indicated that these industry-sponsored events were quite widespread, across various states.  

What this shows, Grundy says, is that while individual health professionals may only attend a few of these events, pharmaceutical companies are sponsoring hundreds of them nationwide.

“When you think of the number of events and the number of health professionals attending these events, what emerges is a picture of a campaign that is able, at a national scale, to amplify perspectives about a promoted drug that are likely favourable to the sponsor,” says Grundy.

The study did not reveal a particular pattern in terms of the types of products that were more likely to be promoted using industry sponsored events. However, there was evidence that two of the top 10 products, both mental health-oriented drugs, had more events for nurse practitioners than physicians, indicating their importance as prescribers in the pharmaceutical market.

In 2021, the first data on industry payments to prescribing nurses was released in the U.S. Grundy says this was an important and positive step towards transparency (Canada lags behind in this regard: there is currently no data or mechanism that requires pharmaceutical or device companies to report payments to physicians or nurse practitioners).

This study, funded by the Greenwall Foundation’s program, is part of a multi-phase project that aims to analyze the new data on industry payments to advanced practice nurses in the U.S.

Grundy says she hopes the research “sparks some conversations in professional circles about how to interact with industry in ways that are in the best interests of population health” – and leads to more research on best practices in prescribing.