The London School of Economics and Political Science, London, UK
Department of Economics and Public Policy, Imperial College London, London, UK.
BMJ Open. 2024 Nov 18;14(11):e091777. doi: 10.1136/bmjopen-2024-091777.
This article critically evaluates the European Commission's 2024 Implementing Regulation (IR) on conflicts of interest (COIs) management for stakeholders in the European Union (EU) Joint Clinical Assessment (JCA), with a focus on individual experts such as clinicians and patient representatives.
The IR is the first EU-level framework to assess COIs in the context of health technology assessment (HTA). The regulation requires experts involved in the JCA to submit annual declarations of interest for both financial and non-financial interests and presents a matrix on whether these conflicts should disqualify them from participating in the joint work. We compared the IR to COIs-management approaches from other European national HTA bodies and found that the IR is closely modelled after the French guidelines. Concerns include potential over-representation of experts from a small number of countries, lack of guidance on organisational COIs, and ambiguities in how the size of financial interests are disclosed. Unclear resource allocation for enforcement could also hinder compliance.
The IR marks progress in EU-wide HTA collaboration, but improvements in transparency, expert diversity, and comprehensive COIs management are needed to ensure impartiality in the JCA process.
本文批判性地评估了欧盟委员会 2024 年关于欧盟联合临床评估(JCA)利益冲突(COI)管理的实施条例(IR),重点关注个体专家,如临床医生和患者代表。
该 IR 是欧盟层面上首次在卫生技术评估(HTA)背景下评估 COI 的框架。该条例要求参与 JCA 的专家提交年度财务和非财务利益利益声明,并提出一个矩阵,以确定这些冲突是否应使他们失去参与联合工作的资格。我们将 IR 与其他欧洲国家 HTA 机构的 COI 管理方法进行了比较,发现 IR 是在法国指南的基础上紧密建模的。关注的问题包括少数国家的专家代表人数过多、缺乏组织 COI 指导、以及披露财务利益规模的模糊性。对执行情况的资源分配不明确也可能阻碍合规性。
IR 标志着欧盟范围内 HTA 合作的进展,但需要在透明度、专家多样性和全面的 COI 管理方面进行改进,以确保 JCA 过程的公正性。