Medicines Transparency Alliance05/09/2015 Medicine Promotion Robert Louie P. So, MD Program Manager...
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Transcript of Medicines Transparency Alliance05/09/2015 Medicine Promotion Robert Louie P. So, MD Program Manager...
Medicines Transparency Alliance19/04/23
Medicine Promotion
Robert Louie P. So, MDProgram ManagerDOH - National Center for Pharmaceutical Access and Management
Medicines Transparency Alliance
Session on Promotion
Wednesday June 30, 2010 lasting an hour and a half
2 presenters, Carole Piriou of HAI gave the keynote while Uganda, through Mr. Nazeem Muhamed, shared with us their country experience
This was followed by a 6-person open fora/panel discussion Chaired by Harvard Professor Michael Reich. Along with the 2 presenters earlier, representatives from Jordan, the Philippines, WHO, and ABPI (Association of the British Pharmaceutical Industry) completed the panel
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Prescribers who rely on promotion as their main source of information tend to prescribe less appropriately, prescribe more often and adopt new medicines faster WHO/HAI 2005 Manufacturing
30%Profits After Taxes) 20%
Taxes/Interest 6%
R&D 13%
Marketing/Admin.31%
Medicines Transparency Alliance
Keynote
Key points of the keynote dwelt on Medicines promotion, how it forges asymmetric information to both providers and patients, and how this adversely affects rational drug use. It was stressed that this irrationality is a GLOBAL problem, experienced even in developed countries, that wastes resources, causes resistance to medications, and is among the leading causes of death and debility
After which the keynote gave glimpses of the aspects of promotion, existing standards on ethical promotion, challenges, sustainable change interventions to limit the undesired impacts of promoting medicines, and some recommendations to move forward
A novel intervention shared in its pilot stages is the HAI/MeTA methodology to assess impact of promotion control. This is envisioned to give evidences that help policy makers improve national policies on promotions. Such was piloted in Uganda
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Medicines Transparency Alliance
The UGANDA experience
UGANDA was one of the countries where the HAI/WHO/MeTA methodology was piloted
The presentation began with a situational analyses, issues and challenges faced, lessons learnt from the pilot tool tested, and recommendations
Noteworthy of the presentation were the following: that ethical standards were not consistent across different, even neighboring, countries, that sales representative are the most common and most effective means of promoting medicines, that the public remained unaware that medicines’ promotion is regulated, and issues on enforcement stymie any progress in correcting the problem and that in the HAI/WHO/MeTA methodology used the Civil Societies played no or minimal roles in regulating and monitoring promotions
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Medicines Transparency Alliance
PANEL: Questions
After stressing that the issue of medicines promotion is a good example of public and private interests coming into direct conflict, as well as the fact that what we are against is UNETHICAL promotions but we allow legitimate promotions, discussions were focused on answering the following key questions:
– What is acceptable promotions?
– Who is responsible to make decisions on this?
– How to implement standards to change what is promoted in the country?
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Medicines Transparency Alliance
PANEL: Thoughts
The regulation of information getting to health care professionals at the early stages of their training
The transparency of declaring and making public perks received from sales representatives to deter or limit unethical practices
That information is available (ex. Through the internet) but which methods are transferrable to countries and what processes?
That there is “no free lunch” and that there are costs to providing good information to all
And that media and its avenues have a very strong influence on patient behavior just as incentives have on professional behavior
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Medicines Transparency Alliance
Open Forum
In certain countries, infractions are published
In some instances, medical representatives are the only source of information. Some companies limit the information given to providers such that the true health risks are sometimes underemphasized
On issues on standards and codes, a MeTA code where expectations from ethical promotions was suggested
Important realities– Companies behave ethically in countries where the codes exist but then do not follow
the same code when they do business elsewhere– The call by companies to comply to ethical marketing standards is not given the same
enthusiasm as their call to contain counterfeit medicines even when both subject people to higher health risks.
– It is important to give information to patients and providers but it is not for industry to take care of this.
– But sources of information is not limited to manufacturers since the whole supply chain gives information (such as dispensers and pharmacists) but manufacturers are critical
– Regulatory Enforcement is weak
Medicines Transparency Alliance
Open Forum
Quotable questions/quotes/solutions When does information become advertising?
What is the most effective role of MeTA to support pharmacists?
Doctor’s entertainment from the pockets of the patients
There is no free lunch. Regulators should regulate information going to doctors
Banning medical representatives as sources of information and limit such to medical journals
Role of MeTA Training of dispensers
Provide platform for exchanges in information
MeTA code and methodology
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Medicines Transparency Alliance
Summary
We want truth in advertising. But who decides? What does it apply to? (traditional/herbal medications)
Promotion identifies conflicts in objectives– Give information. Change behavior in favor of public health– Make money. Change behavior for profits
Revisit the Role of incentives and make it transparent Need for standards and to reconcile if it is acceptable to have
differing standards among different areas Addressing implementation and enforcement issues. Combination
and balance of regulatory tools.– Self regulation is important– Government faces limitations due to resource issues– NGO and individual patient
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Medicines Transparency Alliance
We have products to sell: Rational Drug Precribing,
Dispensing, and Use
Right information at the right time to the right people
People/Patient empowerment and informed choices
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Our Profits: better health outcomes
Medicines Transparency Alliance
Promoting Medicines, promoting MeTA
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We find strength in MeTA
MeTA helps in giving voices
There is strength in unityThere is strength in information
Medicines Transparency Alliance
Thank you
Robert Louie P. So, MD
Email: [email protected], [email protected]
International MeTA Secretariat: [email protected]
MeTA: www.MedicinesTransparency.org
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