Our investigation has for the first time revealed economic links between profiled health care professionals and pharmaceutical companies. Our research is based exclusively on an extensive database research method.
This method shows how far you can get by researching a large amount of data in an innovative way, without using any coding. It also shows that anyone who puts an effort in learning to sort and analyze data with common software can reveal important economic connections.
Our news paper has written about this subject a few years ago. Then we used sources to get estimations on how much money there was exchanged between doctors and pharmaceutical companies. As mentioned above, 2016 these “numbers” were presented as a result of new ethical guidelines in the industry, although it was not searchable. Early I realized that the only way to actually write this story, was to puzzle it together. It took som time and effort to plan the system of how this was to be done (I did it by myself). The idea to look inte this came from my editor in chief, who e-mailed me on my vacation and asked if was possible to investigate these number in any way. I checked the web site and soon realized that it could be done, but that it would demand both time and stubborness. And that it would be very hard to do this investigation without the use of database methods (which I use quite often).
On May 31, 2016 the Swedish Pharmaceutical Industry Organization published data on its website, in line with a new code of conduct in the industry in an effort to make the business more transparent. (http://lif.se/etik/samarbetsdatabaser/?type=Disclosure)
Though the compilation that was published showing individual money transfers from companies, is not searchable in any way. Conclusions from the data can not be made in its original form. A patient can not see if several pharmaceutical companies paid money to a single doctor. Nor is it possible to see if the doctors has received money via their private companies from several big pharma companies.
I worked alone and used Excel and Open refine, and had several weeks to finish my work. 66 pharmaceutical companies were included in the investigation. Data have been converted from 66 separate files (totalling 222 pages), to 66 Excel files (totalling over 4000 rows in 11 columns). The data has then been cleared of errors and has been run through the Open Refine software for name and spelling corrections. We also traced many top doctors who got payments through their private companies, from pharmaceutical companies. We also built a searchable database with private companies that have got payments from the drug industry, companies that are tied to doctors in our investigation.
The result is a searchable database of 1,600 people in health care who had private money transfers from pharmaceutical companies. A second database was constructed, showing payments to over 2000 private enterprises, organizations, hospitals and government agencies. Altogether, we see economic transactions of nearly 170 million swedish kronor. This includes money that has been paid to private doctors for consultation and to private individual companies and hospitals during a year.
We found a large number of top doctors in swedish health care that have had extensive collaborations with the pharmaceutical industry, over 30 doctors received between 100000 kronor to 300000 kronor in private payments during 2015, excluding payments to private companies led by some doctors.
The database has also been matched against all county websites in Sweden (landsting) and various government websites where there are lists of doctors who give advice on drugs. By building complementary smaller data bases we could match names from county web sites to those of our larger database.
In this way, we have revealed extensive links between pharmaceutical companies and persons appointed to decide and advise on drugs on behalf of government authorities.
As we have been able to identify several individuals, it has also been possible to examine whether they have been transparent with their connections to the pharmaceutical industry. The investigation included making extensive controls on how authorities handled these medical experts – did the doctors and scientists tell the authorities that they had been commissioned by the pharmaceutical companies? No, we have in many cases been able to show that they had actively omitted information, which is againts swedish law.
This database investigation has in only a few weeks led authorities to tightening their controls when they appoint medical experts to decide and advise on new drugs. Some of the hired advisors in governmental authorities might have to leave their roles as they have not been open with their ties, or the payments that had been made to them or their own companies.
After our investigation The Parliamentary Ombudsmen (JO) has said that all this in the end poses a risk for patients. There has been an investigation, and I am today (12th of december) waiting for the results from the swedish Medical Products Agency (Läkemedelsverket).
The main obstacle was actually the main source (http://lif.se/etik/samarbetsdatabaser/?type=Disclosure). LIF did’nt help with any of the numbers, nor did they assist in the investigation. So all the calculations (yes, they are correct) had to be done by my me. Hopefully, next year, they will make their web site more friendly for real patients. Or I’ll go back and deep in to the stuff again.