The patient perspective has not been heard during recent debates on healthcare restructuring – this is the unheard voice of the patients. We often assume we know their needs and expectations. But this is not necessarily a failure on our part – its simply about the perspective. I posit that we sitting on a tremendous opportunity, workers in the healthcare sector (we) have a strategic advantage. The good fortune that we have is that not only are we employees of healthcare companies (pharmaceutical industry, medical schemes, academia, consultants, etc.) but we are also patients.
The patient perspective has not been heard during recent debates on healthcare restructuring this is the unheard voice of the patients. We often assume we know their needs and expectations. But this is not necessarily a failure on our part its simply about the perspective. I posit that we sitting on a tremendous opportunity, workers in the healthcare sector (we) have a strategic advantage. The good fortune that we have is that not only are we employees of healthcare companies (pharmaceutical industry, medical schemes, academia, consultants, etc.) but we are also patients. This is a unique position to be in because we are privy to industry-specific information which we use to make more informed decisions. We are also in a unique position to realign decisions to patient needs and expectations. The only reason I introduce this as a topic for further discussion is because I propose that the only legitimate perspective in healthcare decision-making is the perspective of the patient (societal perspective). A patient incurs costs for transportation to healthcare facilities, care-giver time, and an opportunity cost for spending a day at home due to ill health lost income. All other perspectives are partial analytical approaches that provide weak estimates of the impact of healthcare interventions. A funder’s perspective that does not look beyond budgetary impact is illegitimate and should be disband as an inferior analytical approach. The perspective of the government that only includes health-related items on the medium term expenditure framework and medicine tender prices is also a skewed approach to fully understanding the true impact of healthcare interventions. These perspective should be disband in favour of the patient’s perspective. The patient’s perspective should be considered as the only approach with which to encourage transparency of the true cost of healthcare interventions. The true cost of the impact on a patient should reflect as an integral component of all healthcare decision-making.
The American College of Clinical Pharmacy recently updated their Guidelines for Ethical Considerations: Pharmacists and the Pharmaceutical Industry.
The American College of Clinical Pharmacy recently updated their Guidelines for Ethical Considerations: Pharmacists and the Pharmaceutical Industry. The guidelines were published in Pharmacotherapy 2008 28(3) and are available here for online perusal.
The ten guidelines cover numerous subjects such as gifts, managing conflict of interest, modest meals and appropriate honoraria, and continued education. The guidelines “recognize that certain relationships between industry and pharmacists are ethically appropriate, often beneficial, and unavoidable.
The guidelines go beyond defining an ethical relationship between the pharmaceutical industry and clinical pharmacists in hospital and community practice. It also includes pharmacists involved in formulary committees, institutional review boards, and academia (research and education). However, it lacks clarity with respect to pharmacists employed in health insurance companies and pharmaceutical companies.
The guidelines define a conflict of interest as a set of conditions in which professional judgment concerning a primary interest (e.g., research or patient welfare) tends to be unduly influenced by a secondary interest (e.g., financial gain). Arguably, based on this definition of conflict of interest, a pharmacist employed (i.e. for financial gain) in a health insurance company or pharmaceutical company and party to activities that unduly influence her/his professional judgement, has a conflict of interest. Let me expand on this point. A pharmacist employed by a health insurance company who is partly to the development and implementation of a highly restrictive formulary that adversely impacts the quality of life of patients has a conflict of interest. Or, a pharmacist employed by a pharmaceutical company who is involved with setting the pricing policy for a new medicine that is beyond the reach of most patients has a conflict of interest. Does employment in such institutions constitute a conflict of interest when the interests of patients are not fully served? The definition in the guidelines suggests it is.
What are your views?
This news about India’s ascendance to the international IP regimen and the growing importance of its market highlights the inevitable impact it will have in developing countries.
This news about India’s ascendance to the international IP regimen and the growing importance of its market highlights the inevitable impact it will have in developing countries. The assumption is that India (and possibly China) will be able to satisfy its local demand AND supply developing countries with affordable medicines. There is a risk that the continued escalation of chronic diseases, HIV/AIDS, and communicable diseases in China and India will exhaust supply and leave the health care sectors of other developing countries in a vulnerable position. It may be prudent for such countries to explore alternative measures of building their own local industries.
Cheers, Joao
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India must protect its drugmakers from foreign takeover by: Lynne Taylor
India’s government has been told that it must do more to protect the nation’s drugmakers from the threat of takeover by multinational firms.
Since India introduced its new intellectual property regime on January 1, 2005, its drugmakers have become more vulnerable to such threats, according to the final report of a task force set up by the Ministry of Industry and Commerce to propose ways to increase the nation’s drug exports.
India’s pharmaceutical industry is currently “fragmented, with small balance sheet sizes, and takeovers by global drugmakers would adversely affect the health interests of the nation says the task force. There is, therefore, a case to promote internal consolidation and develop stronger companies that have width and depth in market access, manufacturing and R&D.
See the full article here: www.pharmatimes.com/WorldNews/article.aspx?id=15802&src=WorldNewsRSS
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