Veterinary Transparency in Focus: Italy’s Sunshine Act Leading Where the US Transparency Falls Short

Unlike the US Physician Payments Sunshine Act, which mandates disclosure of financial relationships between pharmaceutical companies and physicians but notably excludes veterinarians (except for the state of Minnesota which notably covers veterinarians), Italy’s Sunshine Act, approved in 2022, requires full disclosure of industry payments and transfers of value to all healthcare professionals—including veterinarians. As two of the world’s leading pharmaceutical markets, both the United States and Italy play an outsized role in shaping industry norms. This significant regulatory advancement positions Italy at the forefront of transparency efforts, aiming to build public trust and ensure accountability in veterinary medicine.

From investigations in the US, we have seen that undisclosed financial ties between veterinarians and pharmaceutical manufacturers have been shown to be pervasive. For instance, many veterinarians advising the US FDA on the use of antibiotics have financial relationships with drug companies, including payments, stock ownership, and other benefits, none of which are publicly disclosed. In one report, 11 out of 22 veterinarians advising the FDA on antibiotics had such ties. According to the report:

“Many of these details weren’t disclosed by the FDA. Reuters identified payments to FDA advisory group members by reviewing veterinary journals, industry publications, meeting transcripts, conference programs and resumes, among other sources.”

This lack of transparency undermines public trust and hampers efforts to regulate antibiotic overuse effectively, a concern especially critical given the role of veterinarians in antibiotic stewardship.

Financial conflicts of interest remain a pressing issue. Non-transparent relationships may bias prescribing practices, particularly in food animal medicine where large volumes of pharmaceuticals are dispensed. Critics warn that undisclosed incentives can lead to overuse and inappropriate use of drugs, such as antibiotics, fueling antimicrobial resistance and endangering both animal and human health.

Italy’s move towards veterinary transparency

The Italian Sunshine Act addresses these concerns by mandating that companies disclose payments to individual veterinarians in a centralized, publicly accessible registry called Sanità Trasparente. Once fully operational, this registry will provide unprecedented visibility into the financial relationships within the veterinary sector, promoting ethical behavior and bolstering public confidence.

In contrast, despite recent policy changes in the US, such as expanded FDA labeling requirements for animal drugs in 2024, there is no indication that the US is moving to include veterinarians under its Sunshine Act or any similar transparency law. This regulatory gap persists even as veterinary practices consolidate into large corporate groups, which can introduce uniform business incentives shaping prescription behaviors, sometimes influenced by drug company rebates or promotional contracts. Pet owners and consumer groups have increasingly voiced concern about the lack of transparency around pricing and treatment recommendations.

The ongoing absence of disclosure laws for veterinarians in the US means regulators and the public cannot systematically track industry influence in veterinary medicine. This situation risks excessive prescribing, especially of antibiotics, without adequate professional or public scrutiny. While veterinary organizations defend their members’ ethical standards, critics emphasize the difficulty of addressing hidden conflicts without greater transparency.

A notable distinction is the role of the Farmindustria Code of Conduct in Italy, which primarily governs pharmaceutical companies’ interactions with healthcare professionals involved in human medicine and explicitly excludes veterinarians. Therefore, while veterinarians fall outside this industry self-regulation, they are firmly within the transparency scope of the Italian Sunshine Act, underscoring the law’s broader and more inclusive approach.

Conclusion

Italy’s Sunshine Act marks a pivotal shift in veterinary medicine transparency, setting a new benchmark by including veterinarians in compulsory disclosure of financial relationships with pharmaceutical companies. This move not only enhances accountability and public trust but also addresses critical public health challenges related to drug overuse and antimicrobial resistance. Meanwhile, the persistent exclusion of veterinarians from similar transparency frameworks in countries like the US highlights a significant regulatory gap. Italy’s example could inspire broader reforms worldwide to bring greater clarity, ethics, and responsibility to veterinary-pharma interactions, ultimately benefiting animals, consumers, and public health alike.