Trayer James, Rowbotham Nicola J, Boyle Robert J, Smyth Alan R
Dept of Paediatric Allergy, Imperial College Healthcare NHS Trust, London, UK.
Evidence Based Child Health Group, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.
Breathe (Sheff). 2022 Jun;18(2):220010. doi: 10.1183/20734735.0010-2022. Epub 2022 Jul 12.
Healthcare is a major global industry accounting for a significant proportion of government spending. Drug and medical device manufacturers are publicly traded companies with a responsibility to their shareholders to maximise profits by increasing sales. In order to achieve this, industry exerts influence over every part of healthcare including academic research, medical education, clinical guideline development, physician prescribing and through direct interactions with patients. In contrast, healthcare services seek to provide effective, safe and evidence-based treatments. This article examines interactions with industry across these domains and seeks to identify mutually beneficial relationships and potential conflict leading to patient harms. Case studies are used to illustrate these interactions. There is no single solution for improving healthcare's relationship with industry, although increased transparency has raised awareness of this issue. We briefly discuss some successful interventions that have been tried at national and regulatory level. While industry influence is widespread in healthcare and this has benefits for shareholders, healthcare practitioners have an ethical obligation to prioritise their patients' best interests. Industry interactions with healthcare professionals have a valid role in product development and distribution, but industry sponsorship of healthcare education and practice, guideline development or regulatory decision-making can have harmful consequences for patients. Healthcare practitioners need to carefully consider these issues when deciding whether to collaborate with industry.
To explore the many areas where industry influences healthcare and the subsequent effects on patient care. Case studies are used to illustrate examples of beneficial and harmful effects of this influence.To raise awareness of the effects of industry influence and for readers to consider their own potential conflicts of interest.To suggest potential ways to improve the current system with a focus on solutions which have successfully been trialled already.
医疗保健是一个全球性的主要产业，在政府支出中占很大比例。药品和医疗器械制造商是上市公司，有责任为股东利益最大化，即通过增加销售额来实现利润最大化。为了达到这一目的，该行业对医疗保健的各个方面施加影响，包括学术研究、医学教育、临床指南制定、医生处方以及与患者的直接互动。相比之下，医疗保健服务旨在提供有效、安全且基于证据的治疗。本文探讨了在这些领域与该行业的互动，并试图找出互利关系以及可能导致患者伤害的潜在冲突。通过案例研究来说明这些互动。改善医疗保健与该行业关系没有单一的解决方案，尽管提高透明度已使人们对这个问题有了更多认识。我们简要讨论了一些在国家和监管层面尝试过的成功干预措施。虽然该行业在医疗保健领域的影响广泛，这对股东有利，但医疗从业者有道义上的责任将患者的最大利益放在首位。该行业与医疗专业人员的互动在产品开发和分销中发挥着有效作用，但该行业对医学教育与实践、指南制定或监管决策的资助可能会对患者产生有害影响。医疗从业者在决定是否与该行业合作时需要仔细考虑这些问题。
探讨该行业影响医疗保健的诸多领域以及对患者护理的后续影响。通过案例研究来说明这种影响的有益和有害影响的例子。提高对该行业影响的影响的认识，并让读者考虑自身潜在的利益冲突。提出改善当前系统的潜在方法，重点关注已成功试行的解决方案。
