DOI: 10.14457/tu.the.2016.722
title: Transparency in transfer of value to non-physician healthcare professionals

description: Healthcare is an important factor to escalate Thai citizens’ quality of life. Healthcare professionals are also one of highly respected professions which gain high trust from the public since public opines that they are the ones with best knowledge to provide healthcare service and products and act for the best interest of patients. Hence, drugs and medical supplies are the key factor that can bring about both good and bad effect, not only to patients but also to the country as a whole. As mentioned above that drugs and medical supplies are the key factors in healthcare sector, they are also considered as moral products which can greatly affect the patients’ health since the patients do not have advanced knowledge to select healthcare products and service for themselves, hence, healthcare professionals, whom are trained with advanced knowledge, are the ones who select medical products for the patients. Accordingly, patients themselves are also trust that healthcare professionals provide treatment for their best interest. However, the market of drugs and medical supplies is similar to other markets with companies that aim at making profit in various methods that bring about high competition between companies. Thus, it leads to marketing methods provided by pharmaceutical companies to healthcare professionals, both through their sale representatives and other means, such as conferences, samples, meals, banquets, trips both local and overseas, scholarship and et cetera. Those marketing targeted at healthcare professionals causes conflicts of interests which have numerous negative effects such as irrational drug use, high price of drugs, patients’ health and et cetera. Some might think that physicians play important role, however, there are other kinds of healthcare professionals in healthcare sector, for instance, non – physician healthcare professionals working in the procurement process and the use of drugs and medical supplies. For example, in the process of selecting drugs and medical supplies in Thailand hospitals, there is Pharmacy and Therapeutic Committee or PTC which consists of pharmacists as committee members and secretary of the committee. In drugs and medical supplies procurement process, there are other officers who work in such process, for example, the examination of drugs and medical supplies are conducted by drugs and medical supplies examination committee, the procurement is conducted by procurement officers and other officers. Physicians might not be the only target for pharmaceutical companies’ marketing tactics, accordingly, conflicts of interests might not arise only between physicians but also non – physician healthcare professionals and pharmaceutical companies.In order to gain the best outcome in conflicts of interest reduction and transparency enhancement, physicians should not be the sole target to be regulated, the regulation should also focus on non – physician healthcare professionals since they also play important roles in healthcare sector. Disclosure of benefits, payments and transfers of value provided by pharmaceutical companies to non – physician healthcare professionals is another tool to help transparency enhancement and conflicts of interest reduction. In Thailand, although there are self – regulations, voluntary code and legal provisions, none contains the disclosure obligation about benefits pharmaceutical companies made with non – physician healthcare professionals. For example, related provisions in Thai Criminal Code B.E. 2499 on the offense against officials and misconduct of the government officers which focusing on bribery to government officers, the objectives to punish the violated persons with criminal penalty and the objectives to enhance transparency and reduce conflicts of interests are different. Other kinds of regulations such as notifications or self – regulations not only lack disclosure provision but also effective legal enforcement. Accordingly, transparency plays an important role as a positive effect for patients’ health, reduction in the use of national budget caused by irrational drug use and et cetera. Hence, disclosure of benefits, payments and transfers of value between healthcare professionals and pharmaceutical companies is the key factor to bring transparency in healthcare sector. However, as mentioned above, physicians are not the only professionals working in healthcare sector, leaving other healthcare professionals out of the disclosure obligation can leave loophole which is able to cause ineffectiveness to prevent conflicts of interests. Therefore, non – physician healthcare professionals should be covered in such pharmaceutical companies’ disclosure obligation in any payment, benefit and transfer of value made with non – physician healthcare professionals. In this regards, this thesis studies various kinds of regulation such as international organization criteria, membership self – regulations, European legal provisions, national laws in France and United States in order to find the best model in reduction of conflicts of interests and enhancement of transparency in non – physician healthcare professionals. This thesis provides analysis and suggestion that serves the best interest for Thailand to increase transparency and reduce conflicts of interest between pharmaceutical companies and non – physician healthcare professionals.