doctors for kroner - presentation at #dataharvest 2012
TRANSCRIPT
![Page 1: Doctors for Kroner - Presentation at #Dataharvest 2012](https://reader035.vdocuments.mx/reader035/viewer/2022062512/554ad073b4c90580698b55ce/html5/thumbnails/1.jpg)
Investigating sponsored doctors with spreadsheets
#DataharvestBrussels 6 May 2012
@anpe / [email protected]
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@anpe
• Data journalism for DK media / analytics for Dutch NGOs
• Political scientist by training
• Trying to do more EU journalism
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Two different approaches for investigating?
• What issue do we want to investigate?Letting the issue drive your investigation methodology. If no data available – find them.
• What data can we explore?A reverse approach: We have a data set – what story can we get from it?
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Why investigate doctor-pharma relations?
• +700 mio. dollars from only 12 companies over multi year period in the US
• +200 mio. dollars from the big 3 in 2011 in the US (Source: Pro Publica)
• Why: The doctor is a gate keeper
• The relations are relevant to investigate at several levels: • 1) Contributor to research• 2) Voice in debates on public health• 3) Recommendations made at government levels• 4) Prescriptions in daily treatment of patients
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Inspiration – Dollars for Doctors
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Inspiration: Dollar for Docs
• Documenting relations between doctors and pharmaceutical companies in the US
• Created a database based on web-scraped information
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Taking it to DK: What kind of data is available?
• A spreadsheet of 5000 sponsorship relations between doctors and pharmaceutical companies issued by Danish Medical Authority.
• The list has been available since 2010, according to requirements in Danish legislation.
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The data – ready for download
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Content of data – columns available
Name of doctorSpecialty (orthopeadic, psychiatrist, etc.)Pharmaceutical sponsorData of expiration of sponsorship
•But not available: Work place addressCompany registration or IDAmount paid by pharmaceutical company
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Finding the missing information?
• Public register registered general practitioners with information on doctors, address and specialty
• Data not accessible as download – copied off website.
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How to track a doctor in DK?
• Authorization registry: ca. 270,000Solely a number and thus not useful.
• Public register of 3,000 GP and specialist clinics
Limited information about the individual clinic.Different issuing authority.Different columns and data architecture.
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Copying data the old fashioned way
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How to match names from different databases?
• Example:
• Birgitte E. Jensen is sponsored by Lundbeck
• Gitte Esther Jensen is a GP in Copenhagen
• What to do?
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Matching names in Google Refine
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How does cluster work
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Follow-up checks
• Use “control” columns identified in both data sets
• Check with original raw data
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Getting the data online with Fusion Tables
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A few tips for Fusion Tables
• Use the fusion table format for addresses address, zip, country (some addresses will still be unavailable)
• Prepare the data as much as possible prior to upload in Excel
• Use clear identifiable column headers• Have others test the usability or functionality
of your visualization
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Countrywide: 235 sponsored clinics
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Identifying the extreme cases
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The big picture: Big pharma sponsors lots of doctors
Pfizer
AstraZeneca
Boehringer In
gelheim
Novartis
Merck Sharp
& Dohme
GlaxoSmith
Kline
Bristol-M
yers Squibb
Grünenthal
Sanofi-Aventis
0
50
100
150
200
250
300
350
400
450
Sponsor agreement Employed in DK
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How stories can help build coalitions for better access to data
• March 2012: Danish Regions declines to hand out transparency data for registered doctors: “We do not process individual requests.”
• April: Story published Academics show interest in data.
GP association “We favor transparency, but would have preferred that the data had been compiled by the authorities.”
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Challenges for replicating across Europe:
• Lack of reporting requirements on medical transparency
• Lack of access to lists of registered doctors• Issues are often solved internally between the
industry and doctor associations rather than in public
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A few case countries on transparency
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Norway: Ethical standard, but no transparency
• Response from Norwegian Doctors Association (Legeforeningen): • “Neither the authorities nor the Norwegian Doctors Association
develop lists of doctors with relations to the pharmaceutical industry.”
• “Doctors must adhere to ethical standards…”
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Germany: Studies, but no transparency
• German doctors association (Deutschen Ärzteschaft):
“There isn’t any institution in Germany that functions as a central contact point and covers the collaboration between doctors and pharmaceutical industry in a systematic way. At this time, all existing overviews only describe the types of collaboration, a disclosure about the amount of financial benefit is not designated.”
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Sweden: Doctors and industry settle disputes internally – no transparency
• The Swedish doctors association (Sveriges Läkarförbund):
“Av överenskommelsen framgår att den ska gemensamt utvärderas genom SKL:s och LIF:s samrådsgrupp. Läkemedelsföretagens ev. överträdelser granskas av Informationsgranskningsmannen (IGM) och Nämnden för bedömning av Läkemedelsinformation (NBL).”
”Vi är överens om att sponsring ska präglas av öppenhet.”
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The Netherlands: Transparency from 2013
• The NL doctors association KNMG is assisting implementing this:
• “If the amount of one of more relationships is beyond € 500,- per calendar year, the parties shall disclose within 3 months following the calendar year. The first financial relationships will be published in 2013.”
• The registration will include:• “The nature of agreement;- The name of
pharmaceutical company ;- The name of the medical professional or partnerships of healthcare professionals.”
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DK: Transparency (sort of) in place since ca. 2010
What is disclosed: - Payments, but not in kind transfers (ie. travels)
Who is included?- Authorized doctors and dentists
How specific are the disclosures?- Reporting companies are required to report the receiving physician’s name and role.- The name of product need not to be reported. - Amount is not reported
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US: Health Care reform to push transparency
• Physician Payments Sunshine provisions in Health Care Reform Act (2010) implemented in 2013
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US: The specifics
What will be disclosed: - Payments or in kind transfers (ie. Travels)
Who is included?- Covered recipients include physicians and teaching hospitals.
How specific are the disclosures?- Reporting companies are required to report the receiving physician’s name, address, and national provider identifier.- The name of product promoted must be reported. - Everything above $100 should be reported
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Where to go from here?
• A European doctor transparency register?
• Cross border investigations on multinational pharmaceuticals?