\n\t\t\t\t\tThe payments have raised concerns that doctors could be influenced to favour specific drugs or prescribe them over talking therapies and lifestyle changes\t\t\t\t\t <\/p>\n
NHS <\/a>mental health medics have accepted nearly \u00a31m from pharmaceutical companies<\/a> in the past three years, raising concerns about the potential influence of firms on treatment decisions, The i Paper can reveal.<\/p>\n Major manufacturers of medications for depression<\/a>, anxiety <\/a>and ADHD<\/a> were among firms paying healthcare professionals for a range of things such as contracted services and related expenses. Six of the 10 biggest spenders also paid for registration fees, travel and accommodation. <\/p>\n For example, a consultant psychiatrist may be paid by a pharmaceutical company to speak at a medical conference in order to educate others or share research, and the NHS allows medics to do this in addition to their job in the health service.<\/p>\n But the payments have raised concerns that doctors could be influenced to favour specific \u2013 more expensive \u2013 drugs for mental and neurodevelopmental disorders, or prescribe them over non-pharmaceutical interventions such as talking therapies and lifestyle changes.<\/p>\n The NHS healthcare professionals who were beneficiaries of the payments included doctors, psychologists, consultants, therapists and nurses \u2013 some of whom work with children.<\/p>\n Experts pointed to the opioid crisis in the US<\/a> as a cautionary tale for how financial incentives can affect patient care.<\/p>\n Dr Simon Opher, a Labour MP, GP, and head of the cross-party group on health, called the pharmaceutical company payments \u201ctotally immoral\u201d and said they should be banned. <\/p>\n It comes as growing numbers of Britons are taking medication for mental health <\/a>and neurodevelopmental disorders such as depression, anxiety and ADHD.<\/p>\n Some 8.7 million Britons are taking antidepressants <\/a>\u2013 1.2 million more than in 2018, according to the NHS.<\/p>\n Some 280,000 are taking ADHD drugs, having more than doubled since 2018-19. The number of children taking ADHD tablets rose 10 per cent in the past year to 120,000.<\/p>\n Meanwhile, the Government has announced sweeping work and welfare reforms, including cuts to certain benefits<\/a>, aimed at reducing spending and getting more people into employment.<\/p>\n Health Secretary Wes Streeting<\/a> said in March that he believes there is an \u201coverdiagnosis\u201d of mental health conditions and \u201ctoo many people being written off\u201d work as he defended cuts to personal independent payment and universal credit.<\/p>\n An investigation by The i Paper found data from Disclosure UK \u2013 a database compiled by the Association of the British Pharmaceutical Industry (ABPI) to track payments to doctors \u2013 that shows the number of payments received has grown steadily over the past three years.<\/p>\n NHS healthcare professionals specialising in psychiatry and psychology accepted \u00a3390,000 in 2023 \u2013 the most recent data available. This rose from \u00a3356,000 in 2022 and \u00a3229,000 in 2021, for a total of \u00a3975,000 over the three-year period.<\/p>\n There is no suggestion of rule-breaking by healthcare professionals or pharmaceutical firms. Companies said the payments abide by the ABPI\u2019s code of practice, which says they must not be used as inducements to prescribe.<\/p>\n The code is enforced by the Prescription Medicines Code of Practice Authority, a self-regulatory body.<\/p>\n The data did not cover GPs but included those working for NHS hospitals, trusts and healthcare boards.<\/p>\n How pharma firms \u2018influence\u2019 doctors<\/p>\n \u201cThere is the risk,\u201d said David Rowland, director of the Centre for Health and the Public Interest, \u201cthat if you give \u2018financial incentives\u2019 to doctors, they will provide unnecessary treatment which can end up harming patients.\u201d<\/p>\n He said this was one of the \u201cmost important lessons\u201d that came out of the opioid scandal in the US<\/a> \u2013 doctors prescribing the drugs had received payments from pharmaceutical companies.<\/p>\n Rowland said the payments could lead to patients being \u201cpushed down or encouraged to go down a pharmacological route to treat their condition, as opposed to other interventions like talking therapy or different types of care\u201d.<\/p>\n \u201cThe money is used often to buy influence and to encourage people to look favourably on a particular pharmaceutical company or on a particular product,\u201d he said. \u201cThat\u2019s what\u2019s driving that kind of behaviour from pharmaceutical companies.\u201d<\/p>\n Dr Margaret McCartney, a GP and senior lecturer in medicine at the University of St Andrews, warned of a \u201cmassive conflict of interest\u201d and called for these types of payments and additional earnings to be banned.<\/p>\n \u201cThere\u2019s lots of information, lots of research, that tells us that the more interactions that healthcare systems and professionals have with the pharmaceutical industry, the more likely it is for healthcare to be more expensive and poorer quality,\u201d she said.<\/p>\n She said pharmaceutical companies will often pay for doctors to speak at conferences with the view of making them into key opinion leaders who then give talks and educate other doctors.<\/p>\n The rules on second jobs are relaxed in the NHS. For example, it is currently possible to work as a consultant for the pharmaceutical industry while also being in the position of commissioning or designing NHS services, Dr McCartney said.<\/p>\n She said pharmaceutical companies are keen to work with doctors but it would be far safer for patients for healthcare professionals to avoid working with the industry altogether.<\/p>\n \u201cWhen we get information from the pharmaceutical industry it\u2019s biased in favour of the products they make,\u201d she said. \u201cSometimes these biases can be quite obvious, and sometimes they\u2019re just more subtle.\u201d<\/p>\n An example of a subtle bias could be emphasising the importance of what doctors can prescribe quickly, which can tilt the balance in favour of pharmaceutical treatments for mental health conditions rather than other interventions, which can take months due to long waiting lists<\/a>, she added.<\/p>\n Patients \u2018put on more expensive drugs\u2019<\/p>\n Dr Opher, the Labour MP and GP, warned that patients may be needlessly taking more expensive versions of the same medication.<\/p>\n He said he is seeing people getting discharged from hospital on the newest version of a particular antidepressant rather than a cheaper version of the same drug which has the same efficacy, and suspects this is due to the influence of these payments.<\/p>\n Dr Opher said he believed such payments \u201cwill always cause undue influence on the clinician\u201d and their prescribing decisions, and agreed with calls to ban them.<\/p>\n He said: \u201cIt\u2019s totally immoral. There should be no real interaction between the pharmaceutical companies and doctors.\u201d<\/p>\n Concerns over patient safety<\/p>\n Payments by medical companies to doctors have been linked to one medical scandal in the UK. Some women were left with chronic pain after being given vaginal mesh implants to treat pelvic organ prolapse and incontinence after childbirth. It later emerged that doctors who were promoting them had received payments from the companies making them.<\/p>\n