Presentation at Dataharvest 2012 - Doctors for Kroner

8/2/2019 Presentation at Dataharvest 2012 - Doctors for Kroner

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Investigating sponsored doctors

with spreadsheets#Dataharvest

Brussels 6 May 2012@anpe / [email protected]


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@anpe

Data journalism for DK media / analytics forDutch NGOs

Political scientist by training

Trying to do more EU journalism


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Two different approaches forinvestigating?

What issue do we want to investigate?

Letting the issue drive your investigationmethodology. If no data available find them.

What data can we explore?

A reverse approach: We have a data set whatstory can we get from it?


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Why investigate doctor-pharmarelations?

+700 mio. dollars from only 12 companies over multi yearperiod 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 andpharmaceutical companies in the US

Created a database based on web-scrapedinformation


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Taking it to DK:What kind of data is available?

A spreadsheet of 5000 sponsorship relationsbetween doctors and pharmaceuticalcompanies issued by Danish Medical

Authority.

The list has been available since 2010,according to requirements in Danishlegislation.


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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 sponsor

Data of expiration of sponsorship

But not available:Work place address

Company registration or IDAmount paid by pharmaceutical company


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Finding the missing information?

Public register registered general practitionerswith information on doctors, address andspecialty

Data not accessible as download copied offwebsite.


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How to track a doctor in DK?

Authorization registry: ca. 270,000

Solely a number and thus not useful.

Public register of 3,000 GP and specialistclinics

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 differentdatabases?

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 FusionTables


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A few tips for Fusion Tables

Use the fusion table format for addressesaddress, zip, country (some addresses will stillbe unavailable)

Prepare the data as much as possible prior toupload in Excel

Use clear identifiable column headers

Have others test the usability or functionalityof 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 sponsorslots of doctors

0

50

100

150

200

250

300

350

400

450

Sponsor agreement

Employed in DK


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How stories can help build coalitionsfor better access to data

March 2012:Danish Regions declines to hand out transparency datafor registered doctors: We do not process individualrequests.

April: Story publishedAcademics show interest in data.

GP association We favor transparency, but would havepreferred that the data had been compiled by theauthorities.


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Challenges for replicating acrossEurope:

Lack of reporting requirements on medicaltransparency

Lack of access to lists of registered doctors

Issues are often solved internally between theindustry and doctor associations rather thanin public


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A few case countries ontransparency


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Norway: Ethical standard, but notransparency

Response from Norwegian Doctors Association (Legeforeningen): Neither the authorities nor the Norwegian Doctors Association

develop lists of doctors with relations to the pharmaceuticalindustry.

Doctors must adhere to ethical standards


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Germany: Studies, but no transparency

German doctors association (Deutschenrzteschaft):

There isnt any institution in Germany that

functions as a central contact point and covers thecollaboration between doctors and pharmaceuticalindustry in a systematic way. At this time, all

existing overviews only describe the types ofcollaboration, a disclosure about the amount offinancial benefit is not designated.


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Sweden: Doctors and industry settledisputes internally no transparency

The Swedish doctors association (Sveriges Lkarfrbund):

Av verenskommelsen framgr att den ska gemensamtutvrderas genom SKL:s och LIF:s samrdsgrupp.

Lkemedelsfretagens ev. vertrdelser granskas avInformationsgranskningsmannen (IGM) och Nmnden frbedmning av Lkemedelsinformation (NBL).

Vi r verens om att sponsring ska prglas av ppenhet.


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The Netherlands: Transparency from2013

The NL doctors association KNMG is assistingimplementing this:

If the amount of one of more relationships is beyond

500,- per calendar year, the parties shall disclosewithin 3 months following the calendar year. The firstfinancial relationships will be published in 2013.

The registration will include: The nature of agreement;- The name of

pharmaceutical company ;- The name of the medicalprofessional or partnerships of healthcareprofessionals.


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DK: Transparency (sort of) in placesince 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 thereceiving physicians 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 pushtransparency

Physician Payments Sunshine provisions inHealth Care Reform Act (2010) implementedin 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

physicians 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 multinationalpharmaceuticals?

Presentation at Dataharvest 2012 - Doctors for Kroner

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