Sunshine on KOLs: assessment of the nature, extent and evolution of financial ties between the leaders of professional medical associations and the pharmaceutical industry in France from 2014 to 2019:
OBJECTIVE: To investigate the financial relationships between key opinion leader (KOL) or non-KOL physicians and pharmaceutical and device companies in France. DESIGN: Retrospective and descriptive study. SETTING: All doctors practising in France, with a focus on 548 KOLs (board members of the professional medical associations that published guidelines in 2018-2019, identified on the associations' websites between 2018 and 2020). Ties were collected from the 'Transparency in Healthcare' database. MAIN OUTCOME MEASURES: The number and the value of gifts from 2014 to 2019, and of remunerations and contractual agreements from 2017 to 2019. RESULTS: KOLs represented 0.24% of the total number of physicians in France. The total value of gifts declared in the French database for all physicians amounted to €818M (US$936M, £741M). At least one gift was declared for 83% of KOLs. KOLs' gifts represented 0.68% of the total number of gifts to physicians and 1.5% of the total value of gifts, with a mean of €3700 per capita per year.The total value of contractual agreements declared for all physicians amounted to €125M. Contractual agreements involving the KOLs represented 0.72% of the number of contractual agreements with physicians and 2.5% of the value of the agreements, with a mean of €1900 per capita per year.A total of €156M in remunerations were declared for all physicians. KOL remunerations represented 2.3% of the number of physician remunerations and 4.4% of the total value of the remunerations paid to physicians, with a mean of €4100 per capita per year.Almost all professional medical associations (99%) had at least one KOL in their board with a financial tie to the industry, but the amount varied widely among the associations. CONCLUSION: Financial relationships between KOLs and the industry in France are extensive. KOLs have much more financial ties than non-KOL practitioners.