Medical industry payments to doctors often untraceable

Medical industry payments to doctors are often untraceable and not reported according to the rules, NOS and Nieuwsuur found in a joint investigation. The online register which records these payments is incomplete and flawed, even though Minister Ernst Kuipers of Public Health told parliament early this year that the Transparency Register and self-regulation of doctors, hospitals, and the medical industry were working well.

The Ministry established the Healthcare Transparency Register in 2012 to clarify the commercial interest between pharmaceutical companies and doctors. Suppliers of medical devices joined the register in 2015. The registry is supposed to make it easy for patients to check whether their doctor receives payments from a pharmaceutical, for example.

But Nieuwsuur and NOS found that this does not always work. For example, a cardiologist from Erasmus MC in Rotterdam received almost 70,000 euros from Biotronik, a company that also supplies the hospital with medical devices. They should have registered the payment in the doctor’s name on the Transparency Register. But the payment is registered in the name of the doctor’s private company. Because the outside world does not know about the company, the payments are practically untraceable, the news agencies concluded.

The doctor and hospital acknowledged to NOS that the payment registrations don’t always follow the rules, but they emphasized that there is no conflict of interest. Biotronik did not respond to the broadcaster’s attempts to reach it.

The NOS and Nieuwsuur investigators found hundreds of payments to individual doctors that were made untraceable in similar ways. It involved a total of 14 million euros over three years.

They also found technical flaws in the registry, often encountering error messages. It is also impossible to search the registry for payments. And for months, the registry did not show any payments for the 2018 calendar year, making it seem like doctors received no money in that year.

On Wednesday, NOS reported that cardiologists, in particular, seem to receive a lot of payments from the medical industry without reporting it to their hospitals or on the registry.

Minister Kuipers said he was shocked by this revelation and will talk to the Association for Cardiologists and the Healthcare Inspectorate about the matter, also at the insistence of some parliamentarians.

“That payments from a company go to specialists and hospitals is allowed, but there must be transparency and good agreements between specialists and hospitals,” Kuipers said to the broadcaster.

The foundation behind the Healthcare Transparency Register told NOS that it would investigate the technical issues in the registry, but it cannot assess whether payments are registered correctly. That would require underlying contracts, which are unavailable because they often contain confidentiality clauses.