key opinion leaders
Sunshine on KOL : a retrospective study about financial ties between medical key opinion leaders and pharmaceutical industry in France
ABSTRACT Objective To investigate the nature, extent and evolution of financial relationships between key opinion leaders (KOL) or non-KOL physicians and pharmaceutical and device companies in France. Design Retrospective and descriptive study Setting All doctors practicing in France, with a focus on 548 KOL defined as board members of all the professional medical associations having published clinical practice guidelines in 2018 or 2019. These 99 associations were identified by the cross-checking of 3 databases. Main outcome measures The number and the amount of gifts (year by year since 2014), remunerations and agreements (year by year since 2017). Results Physicians had 818m€ ($936m, £741m) of gifts declared from 2014 to 2019. 83% of KOL had such links of interest. The 548 identified KOL represented 0.24% of physicians in France but received 1.5% of the total amount of gifts, i.e. €12.3m ($14m, £11m or €3 700 per capita per year). Physicians had 125m€ ($143m and 114m£) of agreements declared from 2017 to 2019. The 548 KOL received 0.72% of the agreements and 2.5% of the value of the agreements, i.e. 3.1m€ ($3.6m, £2.8m) or €1 900 per capita per year ($2200, £1700). Physicians had 156m€ ($178m and 141m£) of remunerations declared from 2017 to 2019. The 548 identified KOL received 4.4% of the total value of remunerations to physicians, i.e. 6.8m€ ($7.8m, £6.2m) or 4 100€ per capita per year ($4 800, £3 700). Almost every professional medical associations (99%) had in their board at least one KOL with a financial tie. Conclusion Financial relationships between KOL and the industry in France are extensive, KOL have much more financial ties than non-KOL practitioners. The main limit of this study arises from the quality of information provided on the French Transparency in Healthcare database. Pre-registration: osf.io/m8syh Strengths and limitations of this study This is the first attempt to provide data on the extent of the links of interest between opinion leaders and pharmaceutical industry in France. Author crossed the nationwide databases of financial ties with three databases of professional medical associations. All medical doctors practicing in France were inclused, with a focus on 548 KOL defined as board members of all the professional medical associations having published clinical practice guidelines in 2018 or 2019. These 99 associations were identified by the cross-checking of 3 different catalogs of French professional associations. The major links between key opinion leaders and industry ask the question of the independence of the experts, and raises concern that guidelines can be influenced by industry.