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Sommersguter-Reichmann M, Reichmann G. Untangling the corruption maze: exploring the complexity of corruption in the health sector. HEALTH ECONOMICS REVIEW 2024; 14:50. [PMID: 38995456 PMCID: PMC11241952 DOI: 10.1186/s13561-024-00530-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Healthcare corruption poses a significant threat to individuals, institutions, sectors, and states. Combating corruption is paramount for protecting patients, maintaining the healthcare system's integrity, and preserving public trust. As corruption evolves, takes new forms, and adapts to changing socio-political landscapes, understanding its manifestations is critical to developing effective anti-corruption strategies at individual and institutional levels. OBJECTIVE The aim was to comprehensively collate the manifestations of different types of corruption in healthcare to illustrate prevailing patterns and trends and to provide policymakers, practitioners, and researchers with practical insights to inform research agendas, regulatory and governance strategies, and accountability measures. METHOD We conducted a narrative review of scientific articles published between 2013 and 2022 using keyword searches in SCOPUS and EBSCO. We utilized the corruption typology proposed by the European Union and Thompson's Institutional Corruption Framework to systematically identify manifestations across different corruption types. The Prisma scheme was employed to document the selection process and ensure reproducibility. FINDINGS Bribery in medical service provision was the most frequently investigated form of corruption, revealing rather uniform manifestations. Misuse of high-level positions and networks and institutional corruption also received considerable attention, with a wide range of misconduct identified in institutional corruption. Extending the analysis to institutional corruption also deepened the understanding of misconduct in the context of improper marketing relations and highlighted the involvement of various stakeholders, including academia. The pandemic exacerbated the vulnerability of the healthcare sector to procurement corruption. Also, it fostered new types of misconduct related to the misuse of high-level positions and networks and fraud and embezzlement of medical drugs, devices, and services. CONCLUSIONS The review spotlights criminal actions by individuals and networks and marks a notable shift towards systemic misconduct within specific types of corruption. The findings highlight the necessity of customized anti-corruption strategies throughout the healthcare sector. These insights are crucial for policymakers, practitioners, and researchers in guiding the formulation of legal frameworks at local and global levels, governance strategies, and research priorities.
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Affiliation(s)
| | - Gerhard Reichmann
- Department of Operations and Information Systems, University of Graz, Graz, Austria
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Astărăstoae V, Rogozea LM, Leaşu FG, Roşca S. Drug Promotions Between Ethics, Regulations, and Financial Interests. Am J Ther 2024; 31:e268-e279. [PMID: 38691666 DOI: 10.1097/mjt.0000000000001754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
BACKGROUND The promotion of the latest medicines produced by the pharmaceutical industry is an important issue both from an ethical point of view (the level of accessibility, the way research is carried out) and from the point of view of marketing and especially from the lobbying issues raised. AREAS OF UNCERTAINTY The ethical dilemmas raised by the promotion of new drugs revolve between the need to discover new molecules important for treating a wide range of diseases and the need to establish a battery of ethical rules, absolutely necessary for regulations in the field to be compliant with all ethical principles. DATA SOURCES A literature search was conducted through PubMed, MEDLINE, Plus, Scopus, and Web of Science (2015-2023) using combinations of keywords, including drugs, medical publicity, and pharma marketing plus ethical dilemma. ETHICS AND THERAPEUTIC ADVANCES The promotion of medicines is governed by advertising laws and regulations in many countries, including at EU level, based on the need for countries to ensure that the promotion and advertising of medicines is truthful, based on information understood by consumers. The ethical analysis of the issues raised is more necessary and complex as the channels used for promotion are more accessible to the population, and the information, easier to obtain, can be the cause of increased self-medication and overeating. Large amounts of money invested in the development of new molecules, but also the risk of scientific fraud through manipulation of data during clinical trials, selective or biased publication of information can have repercussions on the health of the population. CONCLUSIONS The development of new pharmaceutical molecules is necessary to intervene and treat as many conditions as possible, but marketing must not neglect the observance of ethical principles. The promotion of medicines should be the attribute especially of the medical staff, which should also be a mandatory part of the mechanism for approving the marketing methods and means used by the pharmaceutical companies.
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Affiliation(s)
- Vasile Astărăstoae
- Faculty of Medicine, Grigore T Popa University of Medicine & Pharmacy, Iasi, Romania
| | - Liliana M Rogozea
- Basic, Preventive and Clinical Sciences Department, Transilvania University, Brasov, Romania; and
| | - Florin Gabriel Leaşu
- Basic, Preventive and Clinical Sciences Department, Transilvania University, Brasov, Romania; and
| | - Stefan Roşca
- Faculty of Medicine and Pharmacy, Universitatea Dunarea de Jos Galati, Galati, Romania
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3
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Panagopoulos A, Sideri K. From lab to mass production: a policy for enabling the licensing of mRNA vaccines. Front Public Health 2023; 11:1151713. [PMID: 37275488 PMCID: PMC10233741 DOI: 10.3389/fpubh.2023.1151713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/13/2023] [Indexed: 06/07/2023] Open
Abstract
Using the South African vaccine technology transfer hub supported by the WHO as an example, we show that the know-how needed to move mRNA vaccines from prototype to mass-production acts as an invisible barrier to market entry of mRNA vaccines. Overcoming this barrier relies on scarce human capital. In view of this scarcity and in preparation for the next pandemic, we propose broadening the scope of an existing WHO program, the WHO Academy, so that it coordinates knowledge diffusion initiatives by forming a systematized repository of know-how and a register of experts. As we explain, this proposal has an advantage in overcoming barriers to entry over current approaches of know-how acquisition.
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Affiliation(s)
- Andreas Panagopoulos
- Department of Economics, Knowledge Transfer Office, TECHNIS, University of Crete, Rethymno, Greece
| | - Katerina Sideri
- Department of Political Science and History, TECHNIS, Panteion University, Athens, Greece
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4
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Noor MN, Rahman-Shepherd A, Siddiqui AR, Aftab W, Shakoor S, Hasan R, Khan M. Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan. BMJ Glob Health 2023; 6:bmjgh-2022-010853. [PMID: 36731921 PMCID: PMC10175940 DOI: 10.1136/bmjgh-2022-010853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/02/2022] [Indexed: 02/04/2023] Open
Abstract
Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different levels and how they collectively contribute to pharmaceutical incentivisation. In addition to influences such as the increasing family needs and peers' financial success, sometimes GPs may naturally be inclined to maximise incomes by engaging in pharmaceutical incentivisation. On other hand, the pharmaceutical market dynamics that involve that competition underpinned by a profit-maximisation mindset enable pharmaceutical companies to meet GPs' desires/needs in return for prescribing their products. Inadequate monitoring and health regulations may further permit the pharmaceutical industry and GPs to sustain the incentive-driven relationship. Our findings have important implications for potential health reforms such as introducing regulatory controls, and appropriate monitoring and regulation of the private health sector, required to address pharmaceutical incentivisation to GPs.
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Affiliation(s)
- Muhammad Naveed Noor
- Pathology and Laboratory Medicine, Aga Khan University, Karachi, Sindh, Pakistan.,Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Afifah Rahman-Shepherd
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Wafa Aftab
- Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Sadia Shakoor
- Pathology and Laboratory Medicine, Aga Khan University, Karachi, Sindh, Pakistan
| | - Rumina Hasan
- Pathology and Laboratory Medicine, Aga Khan University, Karachi, Sindh, Pakistan.,Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Mishal Khan
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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5
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Rocha MDM, de Andrade EP, Alves ER, Cândido JC, Borio MDM. Access to innovative medicines by pharma companies: Sustainable initiatives for global health or useful advertisement? Glob Public Health 2020; 15:777-789. [PMID: 32070242 DOI: 10.1080/17441692.2020.1729391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Research & Development on new medicines plays an important role in life and well-being, making pharmaceutical companies important players in global health. Accessibility and financing new medicines, however, poses challenges for governments and patients around the world. Due to pricing and aggressive patent policy issues, pharma companies started to adopt access to medicines as a strategy to not only improve their public image but also to increase their economic performance. More than a useful institutional advertisement to attract new business, initiatives to improve access to medicines must be socially responsible and sustainable. Using content analysis methodology from CSR reports, the present study evaluated how 44 global companies are positioning themselves regarding access, whether these initiatives are aligned to existing access programmes and whether the actions disclosed on behalf of access are sustainable. We have identified 13 major access to medicines approaches that were classified into intrinsic, potentially sustainable and robust actions. We concluded that companies overvalue the term access to medicine. This can generate initiatives focused on advertisements rather than long-term actions and highlights the need for clear global criteria for companies and programmes that want to effectively publicise access to medicines as a social responsibility strategy.
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6
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Stein GE, Kamler JJ, Chang JS. Ophthalmology Patient Perceptions of Open Payments Information. JAMA Ophthalmol 2018; 136:1375-1381. [PMID: 30242324 DOI: 10.1001/jamaophthalmol.2018.4167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Since 2014, medical industry payment data to physicians have been public via the Open Payments database. Patient opinions regarding these data help us to understand concerns and policymakers to improve reporting mechanisms for such payments. Objective To assess patient perceptions of Open Payments information. Design, Setting, and Participants This cross-sectional, questionnaire-based study was conducted in 3 ophthalmology clinic sites of an academic institution in Manhattan, New York City, New York. All patients older than 18 years who were waiting for appointments were eligible. Data were collected from January to June 2016 and analyzed from June to September 2016. Exposures Participants answered 27 questions about the Open Payments database in English or Spanish. Demographic information was also collected. Main Outcomes and Measures Key questionnaire results included patient awareness of the Open Payments database and perceptions of physicians' financial relationships. Cronbach α validation of the survey was performed, and Poisson multivariable regression analysis was performed to evaluate the association between patient characteristics and responses. Results A total of 407 individuals participated. The mean (SD) age of study participants was 58.8 (17.9) years, and 220 (54.2%) were women. Of these, 30 (7.3% [95% CI, 5.1%-19.4%]) were aware of the Open Payments database, and 109 (26.8% [95% CI, 24.8%-34.0%]) planned to access it. More than half (n = 212; 53.5% [95% CI, 48.6%-58.5%]) wanted to know if their physician receives industry payments. Regarding payments of any kind valuing $100, 161 (41.9% [95% CI, 37.0%-46.9%]) disapproved. Similarly, 178 (45.8% [95% CI, 40.8%-50.7%]) disapproved of $500 payments, and 221 (57.0% [95% CI, 52.0%-61.9%]) disapproved of $25 000 payments. Poisson multivariable regression analysis demonstrated that participants who took the survey in Spanish were 38% more likely to approve of physicians receiving payments than were those who took the survey in English (incidence rate ratio [IRR], 1.38 [95% CI, 1.19-1.59]; P < .001). For every 1 year of age, the likelihood of approval for a physician receiving payments decreased by 1% (IRR, 0.995 [95% CI, 0.99-1.00]; P = .007). Participants with graduate degrees were 20% less likely to approve of physicians receiving payments, compared with those with less than a high school degree (IRR, 0.80 [95% CI, 0.66-0.97]; P = .02). Conclusions and Relevance If the survey is validated, and if these results are generalizable outside of the 3 academic centers in ophthalmology surveyed, the findings suggest that many patients disapprove of physicians receiving payments from industry. However, few patients had accessed the Open Payments database or planned to access it. Further investigation is required to determine if these results can be generalized for other settings.
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Affiliation(s)
- Gregory E Stein
- Department of Ophthalmology, Columbia University Medical Center, New York, New York.,Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan J Kamler
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Jonathan S Chang
- Department of Ophthalmology, Columbia University Medical Center, New York, New York.,Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
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7
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Sommersguter-Reichmann M, Wild C, Stepan A, Reichmann G, Fried A. Individual and Institutional Corruption in European and US Healthcare: Overview and Link of Various Corruption Typologies. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2018; 16:289-302. [PMID: 29572725 PMCID: PMC5940713 DOI: 10.1007/s40258-018-0386-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In recent years, the fight against healthcare corruption has intensified. Estimates from the European Healthcare Fraud and Corruption Network calculate an approximate €56 billion annual loss to Europe as a result of corruption. To promote understanding of the complexity and interconnection of corrupt activities, we aim to present healthcare-related corruption typologies of the European Union and European Healthcare Fraud and Corruption Network. We subsequently link them to the typology of individual and institutional corruption introduced by Dennis Thompson in the context of investigating misconduct of US Congressional members. According to Thompson, individual corruption is the personal gain of individuals performing duties within an institution in exchange for nurturing private interests, while institutional corruption pertains to the failure of the institution in directing the individual's behaviour towards the achievement of the institution's primary purpose because the institutional design promotes the pursuit of individual goals. Effective anti-corruption activities not only require the enactment of anti-corruption laws but also the monitoring and, where appropriate, revision of institutional frameworks to prevent the undermining of the primary purposes of health systems or institutions. To gain further understanding of the similarities and differences of the three typologies, prime examples of corrupt activities in the health sector in the European Union and USA (along with their potential remedies) are provided. Linking corruption cases to Thompson's typology revealed that many corrupt activities may show elements of both individual and institutional corruption because they are intertwined, partly overlap and may occur jointly. Hence, sanctioning individual actors only does not target the problem.
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Affiliation(s)
| | - Claudia Wild
- Ludwig Boltzmann Institute of Health Technology Assessment, Vienna, Austria
| | - Adolf Stepan
- Institute of Management Science, Technical University Vienna, Vienna, Austria
| | - Gerhard Reichmann
- Department of Information Science and Information Systems, Karl-Franzens University of Graz, Graz, Austria
| | - Andrea Fried
- Transparency International-Austrian Chapter, Vienna, Austria
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8
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The Accuracy of Conflict-of-Interest Disclosures Reported by Plastic Surgeons and Industry. Plast Reconstr Surg 2018; 141:1592-1599. [DOI: 10.1097/prs.0000000000004380] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Purvis TE, Lopez J, Milton J, May JW, Dorafshar AH. Plastic Surgeons' Perceptions of Financial Conflicts of Interest and the Sunshine Act. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1733. [PMID: 29876177 PMCID: PMC5977953 DOI: 10.1097/gox.0000000000001733] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/06/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND It is unknown whether recent legislation known as the Physician Payments Sunshine Act has affected plastic surgeons' views of conflicts of interest (COI). The purpose of this study was to evaluate plastic surgeons' beliefs about COI and their comprehension of the government-mandated Sunshine Act. METHODS Plastic surgeon members of the American Society of Plastic Surgeons were invited to complete an electronic survey. The survey contained 27 questions that assessed respondents' past and future receipt of financial gifts from industry, awareness of the Sunshine Act, and beliefs surrounding the influence of COI on surgical practice. RESULTS A total of 322 individuals completed the survey. A majority had previously accepted gifts from industry (n = 236; 75%) and would accept future gifts (n = 181; 58%). Most respondents believed that COI would affect their colleagues' medical practice (n = 190; 61%) but not their own (n = 165; 51%). A majority was aware of the Sunshine Act (n = 272; 89%) and supported data collection on surgeon COI (n = 224; 73%). A larger proportion of young surgeons believed patients would benefit from knowing their surgeon's COI (P = 0.0366). Surgeons who did not expect COI in the future believed financial COI could affect their own clinical practice (P = 0.0221). CONCLUSIONS Most plastic surgeons have a history of accepting industry gifts but refute their influence on personal clinical practice. Surgeon age and anticipation of future COI affected beliefs about the benefits of COI disclosure to patients and the influence of COI on surgical practice.
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Affiliation(s)
- Taylor E. Purvis
- From the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Md
| | - Joseph Lopez
- From the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Md
| | | | - James W. May
- Division of Plastic & Reconstructive Surgery, Massachusetts General Hospital, Boston, Mass
| | - Amir H. Dorafshar
- From the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Md
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10
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Shi J, Liu R, Jiang H, Wang C, Xiao Y, Liu N, Wang Z, Shi L. Moving towards a better path? A mixed-method examination of China's reforms to remedy medical corruption from pharmaceutical firms. BMJ Open 2018; 8:e018513. [PMID: 29439069 PMCID: PMC5829841 DOI: 10.1136/bmjopen-2017-018513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Few studies have systematically examined the effects of the existing regulations for alleviating corruption in China. This study assesses the effectiveness of China's reforms to curb medical corruption. METHODS We used mixed methods for the evaluation of existing countermeasures. First, qualitative informant interviews based on the Donabedian model were conducted to obtain experts' evaluation of various kinds of countermeasures. Second, using data from 'China Judgements Online', we analysed the trend of occurrence and the characteristics of the medical corruption cases in recent years to reflect the overall effects of these countermeasures in China. RESULTS Since 1990s, China has implemented three main categories of countermeasures to oppose medical corruption: fines and criminal penalties, health policy regulations, and reporting scheme policy. Information from the interviews showed that first the level of fines and criminal penalties for medical corruption behaviours may not be sufficient. Second, health policy regulations are also insufficient. Although the National Reimbursement Drug List and Essential Drug List were implemented, they were incomplete and created additional opportunities for corruption. Moreover, the new programme that centralised the purchase of pharmaceuticals found that most purchasing committees were not independent, and the selection criteria for bidding lacked scientific evidence. Third, the reporting scheme for commercial bribery records by the health bureau was executed poorly. In addition, quantitative online data showed no obvious decrease of institutional medical corruption in recent years, and most criminals have been committing crimes for a long time before getting detected, which further demonstrated the low effectiveness of the above countermeasures. CONCLUSIONS Although existing countermeasures have exerted certain effects according to Chinese experts, more rigorous legislation and well-functioning administrative mechanisms are needed. Fundamentally, financial incentives for hospitals/physicians and the health insurance system should be improved.
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Affiliation(s)
- Jianwei Shi
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Health Policy and Management, Primary Care Policy Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rui Liu
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hua Jiang
- Department of Family Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chunxu Wang
- Tongji University School of Medicine, Shanghai, China
| | - Yue Xiao
- Tongji University School of Medicine, Shanghai, China
| | - Nana Liu
- Tongji University School of Medicine, Shanghai, China
| | - Zhaoxin Wang
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Tongji University School of Medicine, Shanghai, China
| | - Leiyu Shi
- Department of Health Policy and Management, Primary Care Policy Center, Johns Hopkins University, Baltimore, Maryland, USA
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11
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Sommersguter-Reichmann M, Stepan A. Hospital physician payment mechanisms in Austria: do they provide gateways to institutional corruption? HEALTH ECONOMICS REVIEW 2017; 7:11. [PMID: 28251553 PMCID: PMC5332321 DOI: 10.1186/s13561-017-0148-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/21/2017] [Indexed: 06/06/2023]
Abstract
Institutional corruption in the health care sector has gained considerable attention during recent years, as it acknowledges the fact that service providers who are acting in accordance with the institutional and environmental settings can nevertheless undermine a health care system's purposes as a result of the (financial) conflicts of interest to which the service providers are exposed. The present analysis aims to contribute to the examination of institutional corruption in the health sector by analyzing whether the current payment mechanism of separately remunerating salaried hospital physicians for treating supplementary insured patients in public hospitals, in combination with the public hospital physician's possibility of taking up dual practice as a self-employed physician with a private practice and/or as an attending physician in private hospitals, has the potential to undermine the primary purposes of the Austrian public health care system. Based on the analysis of the institutional design of the Austrian public hospital sector, legal provisions and directives have been identified, which have the potential to promote conduct on the part of the public hospital physician that systematically undermines the achievement of the Austrian public health system's primary purposes.
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Affiliation(s)
| | - Adolf Stepan
- Institute of Management Science, Technical University Vienna, Theresianumgasse 27, A-1040 Vienna, Austria
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12
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Disclosure of Financial Conflicts of Interest in Plastic and Reconstructive Surgery. Plast Reconstr Surg 2017; 140:635-639. [DOI: 10.1097/prs.0000000000003598] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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David-Barrett E, Yakis-Douglas B, Moss-Cowan A, Nguyen Y. A Bitter Pill? Institutional Corruption and the Challenge of Antibribery Compliance in the Pharmaceutical Sector. JOURNAL OF MANAGEMENT INQUIRY 2017. [DOI: 10.1177/1056492617696885] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigate why top-down directives aimed at eradicating corruption are ineffective at altering on-the-ground practices for organizations that have adopted industry-wide “gold standards” to prevent bribery and corruption. Using interview and focus group data collected from leading multinational pharmaceutical firms, we unearth antecedents contributing to organizations’ systemic failure to embed their anticorruption policies in business practice. We identify two tensions that contribute to this disconnect: a culture clash between global and local norms, especially in emerging markets and a similar disconnect between the compliance and commercial functions. To overcome these tensions, we suggest that organizations are likely to find it easier to implement a no gifts policy if they cease to rely on local agents embedded in local norms and that there needs to be strong evidence of board-level commitment to antibribery programs, innovative ways of incentivizing compliant behavior, and a fundamental rethinking of organizations’ business model and remuneration practices.
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Affiliation(s)
| | | | | | - Yen Nguyen
- Global Commercial Strategy Organization, NJ, USA
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14
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Monro M, Farwell S, Downes W, Wilson M, Carter PV, Douglas-Mort D, Möckel E, Zwierzchowska Z, Apeztegia J. Response to the Editorial “The enigmatic case of cranial osteopathy: Evidence vs clinical practice”. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Godman B, Malmström RE, Diogene E, Gray A, Jayathissa S, Timoney A, Acurcio F, Alkan A, Brzezinska A, Bucsics A, Campbell SM, Czeczot J, de Bruyn W, Eriksson I, Yusof FAM, Finlayson AE, Fürst J, Garuoliene K, Guerra Júnior A, Gulbinovič J, Jan S, Joppi R, Kalaba M, Magnisson E, McCullagh L, Miikkulainen K, Ofierska-Sujkowska G, Pedersen HB, Selke G, Sermet C, Spillane S, Supian A, Truter I, Vlahović-Palčevski V, Vien LE, Vural EH, Wale J, Władysiuk M, Zeng W, Gustafsson LL. Are new models needed to optimize the utilization of new medicines to sustain healthcare systems? Expert Rev Clin Pharmacol 2015; 8:77-94. [PMID: 25487078 DOI: 10.1586/17512433.2015.990380] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. A number of issues and challenges were identified from the case histories. These included the low number of new medicines seen as innovative alongside increasing requested prices for their reimbursement, especially for oncology, orphan diseases, diabetes and HCV. Proposed models center on the three pillars of pre-, peri- and post-launch including critical drug evaluation, as well as multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure. In conclusion, the proposed models involving all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.
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Affiliation(s)
- Brian Godman
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Abstract
The Physician Payments Sunshine Act is a disclosure law requiring all drug, medical device, and biologics companies to report transfers of value to physicians and teaching hospitals. It was passed into law in 2010 as part of the Affordable Care Act. The first set of data was released via an online public database on September 30, 2014, with subsequent annual reports to come. Three categories of payments are recorded: general payments, ownership interests, and research payments. With few exceptions, any transfer of value greater than $10 is reported. The first dataset of 4.4 million payments totaling more than $3.5 billion was released amidst controversy and technical problems. Identified data constituted $1.3 billion in transfer payments; de-identified data constituted $2.2 billion in payments. Data regarding an additional $1.1 billion in payments were not published, in part because of unresolved disputes. The largest amount of funding went to research payments. The highest proportion of general payments went to licensing and royalty payments. Orthopaedic surgeons comprised 3.5% of the physicians represented, and they were responsible for more than 20% of total payments. The full impact of the Sunshine Act will not be clear until several years after its implementation.
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Krieger N. Public Health, Embodied History, and Social Justice: Looking Forward. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2015; 45:587-600. [PMID: 26182941 DOI: 10.1177/0020731415595549] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This essay was delivered as a commencement address at the University of California-Berkeley School of Public Health on May 17, 2015. Reflecting on events spanning from 1990 to 1999 to 2015, when I gave my first, second, and third commencement talks at the school, I discuss four notable features of our present era and offer five insights for ensuring that health equity be the guiding star to orient us all. The four notable features are: (1) growing recognition of the planetary emergency of global climate change; (2) almost daily headlines about armed conflicts and atrocities; (3) growing public awareness of and debate about epic levels of income and wealth inequalities; and (4) growing activism about police killings and, more broadly, "Black Lives Matter." The five insights are: (1) public health is a public good, not a commodity; (2) the "tragedy of the commons" is a canard; the lack of a common good is what ails us; (3) good science is not enough, and bad science is harmful; (4) good evidence--however vital--is not enough to change the world; and (5) history is vital, because we live our history, embodied. Our goal: a just and sustainable world in which we and every being on this planet may truly thrive.
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Affiliation(s)
- Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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18
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Darnall BD, Schatman ME. Toward the Healthiest Symbiosis. PAIN MEDICINE 2015; 16:1254-5. [DOI: 10.1111/pme.12828_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Beth D Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA
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19
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Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag 2015; 4:61-4. [PMID: 25674569 DOI: 10.15171/ijhpm.2015.24] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 02/02/2015] [Indexed: 11/09/2022] Open
Abstract
In response to the questioning of Health Policy and Management (HPAM) by colleagues on the role of rank and file family physicians in the same journal, the author, a family physician in Belgium, is trying to highlight the complexity and depth of the work of his colleagues and their contribution to the understanding of the organization and economy of healthcare. It addresses, in particular, the management of health elements throughout the ongoing relationship of the family doctor with his/her patients. It shows how the three dimensions of prevention, clearly included in the daily work, are complemented with the fourth dimension, quaternary prevention or prevention of medicine itself, whose understanding could help to control the economic and human costs of healthcare.
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Affiliation(s)
- Marc Jamoulle
- Espace Temps, Maison de Santé, Charleroi, Belgium, and Department of General Practice, University of Liege, Liège, Belgium
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20
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Abstract
Research shows that many organizations overlook needs and opportunities to strengthen ethics. Barriers can make it hard to see the need for stronger ethics and even harder to take effective action. These barriers include the organization's misleading use of language, misuse of an ethics code, culture of silence, strategies of justification, institutional betrayal, and ethical fallacies. Ethics placebos tend to take the place of steps to see, solve, and prevent problems. This article reviews relevant research and specific steps that create change.
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Affiliation(s)
- Kenneth S Pope
- a Licensed Psychologist in Independent Practice, Norwalk , Connecticut , USA
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21
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Elliott C. Relationships between physicians and Pharma: Why physicians should not accept money from the pharmaceutical industry. Neurol Clin Pract 2014; 4:164-167. [PMID: 29443239 DOI: 10.1212/cpj.0000000000000012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Carl Elliott
- Center for Bioethics, University of Minnesota, Minneapolis
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