Policy Statement 5.12 - The Relationship between Dentists and the Pharmaceutical Industry

Position Summary

The primary objective of the professional interaction between dentists and the pharmaceutical industry should be the optimisation of the health of patients. Research projects requiring active cooperation between the dental profession and the pharmaceutical industry should be conducted under strict ethical guidelines.

1. Background

1.1. The use of products produced by the pharmaceutical industry form an important part of the practice of dentistry.

1.2. The pharmaceutical industry and dentists interact in the following areas where dentists:

• Obtain, possess, administer, supply and prescribe drugs in the practice of dentistry;

• recommend the use of other pharmaceutical products;

• receive complementary information and promotional products from the pharmaceutical industry; and

• are involved in research and Continuing Professional Development (CPD) activities in conjunction with the pharmaceutical industry.

1.3. Transparency of arrangements between dentists and the pharmaceutical industry will improve confidence in the self-government role of the dental profession and ensure the best patient outcomes.

1.4. Pharmacists have a valuable role in supporting the dentists’ management of patients with regard to medications.

1.5. Building a relationship and good communication between dentists and local pharmacists ensures optimal patient care delivery.

1.6. It is important that dental students are adequately trained in the ethical issues surrounding the use of pharmaceutical products.

Definition

1.7. PHARMACEUTICAL INDUSTRY is industry involved in the development, testing, manufacturing, compounding, wholesaling and marketing of drugs and other medicinal products.

2. Position

2.1. Professional interactions between dentists and the pharmaceutical industry should have as their primary objective the advancement of the health of patients and the community rather than the commercial interests of either dentists or the industry.

2.2. When obtaining, possessing, administering, supplying and prescribing pharmaceutical products dentists should:

• only administer, supply and prescribe drugs for the practice of dentistry;

• have the advancement of the health of patients as their primary objective;

• not supply pharmaceutical products unless there is no reasonable alternative;

• not allow their prescribing habits or use of products to be influenced by personal gifts or incentives from the pharmaceutical industry or similar bodies;

• maintain professional autonomy, independence and commitment to the scientific method; and

• ensure that the patient or their carer understands the reason for the use of the medication, its dosage and any potential adverse reactions that the medication may cause.

• be familiar with and have the relevant prescribing competencies defined in the ‘Prescribing Competencies Framework’.

2.3. CPD and education regarding pharmaceutical products is essential for dentists to be well informed, and the pharmaceutical industry may contribute to such events, provided:

• they address the educational needs of the targeted dental audience and not the marketing needs of the contributing pharmaceutical company;

• the organisation, control and choice of CPD activities must be approved by dentists;

• CPD organisers and their delegates are not in a position of conflict of interest by virtue of any affiliation with the sponsors of those activities;

• any funding arrangements with a sponsoring company are declared;

• financial and/or other incentives received are acknowledged in the program;

• the sponsor’s product is not excessively promoted; and

• travel and accommodation arrangements, social events and venues for industry sponsored CPD activities are in keeping with the arrangements which would be in place in the absence of industry sponsorship.

2.4. When dental research requires the active cooperation between the dental profession and the pharmaceutical industry:

• dentists and dental researchers should satisfy themselves that the project has genuine merit, is not detrimental to the development of other more appropriate areas of research and is ethically sound, socially responsible and scientifically valid;

• the participation of dentists in research activities sponsored by the pharmaceutical industry should always be preceded by formal approval of the project by an appropriate review body, which should also receive a report upon its completion and such review should follow national guidelines of the type promulgated by the National Health and Medical Research Council’s Australian Health Ethics Committee and similar bodies; and

• all monies provided for research should be held in trust for the specified purposes, and such an account should be available for audit.

2.5. Dentists should not:

• be affiliated with the pharmaceutical industry if the nature of their affiliation influences their dental practice in an inappropriate fashion;

• knowingly invest in pharmaceutical companies where the investment might influence
inappropriately the manner of their practice or their prescribing behavior; nor

• accept a fee or incentive from pharmaceutical manufacturers or distributors in exchange for participating in promotional or similar activities.

• promote products in an unregulated fashion.

2.6. Dentists may accept educational materials from pharmaceutical companies appropriate to their areas of practice.

2.7. The curricula of Dental Schools should include formal training on the ethical association between dentists and the pharmaceutical industry

2.8. The pharmaceutical industry should where possible, eliminate sugars and acids as additives in medications taken orally.

2.9. Compounded medicines are prescribed for individual patients only, and dentists should follow state regulations regarding the possession, acquisition, supply and advertising of compounded pharmaceuticals.

2.1. Third parties must not influence the primary relationship between the dentist and the patient in any way that diminishes a patient’s right to achieve long term optimum oral health.

2.2. Third Parties must provide equal rebates to patients for the same dental service under the same policy and this should be enforced by Government intervention.

2.3. Third Parties should not limit or influence the patient’s choice of dental provider.

2.4. Third parties should not impose business rules that favour any particular dentist or prevent patients from accessing rebates for appropriate dental care.

2.5. All dentists should be treated equally by Third Parties.

2.6. All Third Parties must use the current version of the ADA’s The Australian Schedule of Dental Services and Glossary which is the recognised definitive uniform coding system for dental services in Australia, which should be easily accessible.

2.7. Third party complaints resolution mechanisms must be transparent and procedurally fair for patients and dentists.

2.8. Rating sites for dentists should not be published and governments should legislate to prevent them.