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医药行业透明度:来自发展中国家的关键知情人的看法。

Transparency in public pharmaceutical sector: the key informants' perceptions from a developing country.

机构信息

Department of Health Policy & Management, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

BMC Health Serv Res. 2021 Dec 7;21(1):1316. doi: 10.1186/s12913-021-07319-x.

Abstract

BACKGROUND

Policymaking in the pharmaceutical sector plays a pivotal role in achieving the health systems' goals. Transparency in the pharmaceutical policy could increase confidence in decision-making processes. This study aims to assess transparency in the public pharmaceutical sector of Iran.

METHODS

This qualitative study with a content analysis approach was conducted in 2017 using the World Health Organization tool to explore pharmaceutical transparency. The perceptions of the various stakeholders of the health system through semi-structured interviews with a maximum variation of stakeholders were obtained in eight functions, including registration, licensing, inspection, promotion, clinical trials, selection, procurement, and distribution of medicines.

RESULTS

There are some problems in two main categories: (1) General problems, including lack of transparency, conflict of interest, centralization, and monopoly. (2) Ethical problems include illegal payments, gifts, bribes, conflicts of interest, hidden power, hoarding, relationship-oriented behavior, medicine trafficking, and counterfeit medicine. Suggested solutions include evidence-based decision-making, the use of transparent and accountable processes, standardization, needs assessment, declaring a conflict of interest, skilled human resources, and tracking prescription.

CONCLUSION

Despite the development of effective pharmaceutical policy in the health care system and government interventions for the control of the market, in some functions, reviewing the pharmaceutical policy is essential. Additionally, declaring a conflict of interest statement must be at the core of policy development to provide greater transparency.

摘要

背景

制药政策在实现卫生系统目标方面发挥着关键作用。制药政策的透明度可以增加对决策过程的信心。本研究旨在评估伊朗公共制药部门的透明度。

方法

这是一项 2017 年进行的定性研究,采用内容分析法,使用世界卫生组织工具来探讨制药透明度。通过对卫生系统各利益相关者进行半结构化访谈,获得了各利益相关者的最大差异,涵盖了注册、许可、检查、推广、临床试验、选择、采购和药品分销等八个功能。

结果

存在两个主要类别的一些问题:(1)一般问题,包括缺乏透明度、利益冲突、集中化和垄断。(2)道德问题,包括非法支付、礼物、贿赂、利益冲突、隐藏权力、囤货、关系导向行为、药品走私和假药。建议的解决方案包括基于证据的决策、使用透明和负责任的流程、标准化、需求评估、声明利益冲突、有技能的人力资源和跟踪处方。

结论

尽管医疗保健系统制定了有效的制药政策和政府干预措施来控制市场,但在某些功能方面,审查制药政策至关重要。此外,声明利益冲突声明必须是政策制定的核心,以提供更大的透明度。

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