Healthcare is a complex system in which many actors and interests play a role. Unfortunately, the representation of some prevails over others, quite often even over patients’ interest, despite the fact that the whole system’s aim is to work for their well-being and safety.
In mental health, in particular, industry and healthcare professionals have had a long-standing dual relationship too often qualified by a lack of transparency. This has led to over-reliance on a very narrow biomedical approach to mental healthcare and over-prescription of medication with little scope for users to make informed choices about their care.
To ensure the adequate balance of interests in the system, we need more transparency at various levels. But how does transparency fit this picture, and does it matter at all to patients?
I believe that patients and users are truly interested in and have a right to know who their providers cooperate with and where they get their knowledge from. Even if not directly by consulting public registers or companies’ websites – they always look for the best quality of care for themselves and their relatives and the highest possible competencies of medical staff. Patients and users are growingly becoming aware of the existing conflicts of interest in the medical practice and the ways they can affect the quality of care they receive. However, I think their right to assess and evaluate possible barriers to the full enjoyment of the highest quality of care is not exercised enough. Some legislative steps can be taken in order to improve this.
In Europe, nine countries have already decided to introduce legally binding sunshine laws – in various forms. All this is done not to add to the current administrative burden for the companies, but to answer legitimate public concerns about the undue impact of industrial partners active in healthcare. I strongly believe that more countries will follow. Considering what is already known about the impact of conflicts of interest on medical practice e.g. altered prescribing behaviours or biased clinical practice guidelines, it is important to implement effective transparency mechanisms that ensure sufficient information on payments and recipients, high HCP consent rate and inclusion of R&D related transfers.
Those mechanisms should be harmonised across countries. There is a role to be played for the European Union in order to strengthen and align transparency provisions. There is already an existing ground of self-regulation and national legislation on which we can build. I believe this will be supported both by the industry and the general public, making it easier for the industry to comply with international standards and for the public to access, analyse and inform their health choices.
This blog is part of the MedTech Forum blog series. Marcin Rodzinka will be speaking at the MedTech Forum and Global MedTech Compliance Conference 2019. You can follow the conversation under #MTF2019 and find more details at medtechforum.eu.
