Healthcare and the pharmaceutical lobby
A dangerous relationship
DOI:
https://doi.org/10.20318/recs.2025.8878Keywords:
Primary Health Care, communication, social responsibility, medical ethics, drug industry, public healthAbstract
This article explores the complex and often problematic relationships between the healthcare system and the pharmaceutical lobby, with a particular focus on the dynamics in primary care. It analyses how pharmaceutical multinationals exert their influence through lobbying activities, which, at a professional level, compromise transparency and independence in clinical decision-making. In healthcare systems, these practices include setting high prices, extending patents and using marketing strategies that can distort medical care, impacting both the sustainability of the National Health System (NHS) and the quality of care received by patients. Furthermore, the text highlights the fundamental role of Primary Care (PC) as a key pillar to counteract these influences. PC, with its patient-centred approach and evidence-based medicine, can act as a brake on commercial interests. In this context, the importance of transparent and responsible communication is underlined to ensure that medical decisions continue to prioritise public health. Finally, the article calls for reforms to promote transparency and safeguard the integrity of the health system.
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References
Alhiary, R., Kesselheim, A. S., Gabriele, S., Beall, R. F., Tu, S. S., & Feldman, W. B. (2023). Patents and regulatory exclusivities on GLP-1 receptor agonists. JAMA, 330(7), 650-657. doi:10.1001/jama.2023.13872
Altisent, R., Delgado-Marroquín, M. T., & Astier-Peña, M. P. (2019). Conflictos de interés en la profesión médica. Atención Primaria, 51(8), 506-511. https://doi.org/10.1016/j.aprim.2019.05.004
Angell, M., & Angell, M. (2005). The truth about the drug companies: How they deceive us and what to do about it (p. 9). New York: Random House Trade Paperbacks. https://www.bmj.com/content/bmj/329/7470/Reviews.full.pdf
Brinkhuis, F., Goettsch, W. G., Mantel-Teeuwisse, A. K., & Bloem, L. T. (2024). High cost oncology drugs without proof of added benefit are burdening health systems. BMJ, 384. https://doi.org/10.1136/bmj.q511
Chimonas, S., Mamoor, M., Zimbalist, S. A., Barrow, B., Bach, P. B., & Korenstein, D. (2021). Mapping conflict of interests: scoping review. BMJ, 375. https://doi.org/10.1136/bmj-2021-066576
Civio. (23 octubre 2017). English and Swiss doctors are more transparent than German and Spanish ones [Internet]. Madrid: Fundación Ciudadana Civio. [citado 26 agosto 2024]. https://civio.es/medicamentalia/2017/10/23/english-and-swiss-doctors-more-transparent-than-german-and-spanish-ones/
Consejo General de Colegios Oficiales de Farmacéuticos. (2015). Colaboración entre profesionales sanitarios, clave en la Sanidad del futuro. Recuperado de: https://www.farmaceuticos.com/wp-content/uploads/2021/02/XIX-CNF-Informe-Colaboracion-entre-Profesionales-Sanitarios.pdf
DiMasi, J. A., Grabowski, H. G., & Hansen, R. W. (2016). Innovation in the pharmaceutical industry: new estimates of R&D costs. Journal of health economics, 47, 20-33. https://doi.org/10.1016/j.jhealeco.2016.01.012
Fuentes-Colmenero, A. L. (2019). Características de la comunicación entre profesionales de enfermería y medicina para la seguridad del paciente. Revista Española de Comunicación en Salud, 10(2), 160-170. https://doi.org/10.20318/recs.2019.4326
Fugh-Berman, A. (2021). Industry-funded medical education is always promotion—an essay by Adriane Fugh-Berman. BMJ, 373. https://doi.org/10.1136/bmj.n1273
Gazendam, A. M., Slawaska-Eng, D., Nucci, N., Bhatt, O., & Ghert, M. (2022). The impact of industry funding on randomized controlled trials of biologic therapies. Medicines, 9(3), 18. https://doi.org/10.3390/medicines9030018
Gøtzsche, P. C. (2018). Patients not patents: drug research and development as a public enterprise. European Journal of Clinical Investigation, 48(2). https://doi.org/10.1111%2Feci.12875
Hemphill, C. S. (2006). Paying for delay: Pharmaceutical patent settlement as a regulatory design problem. NYUL Rev., 81, 1553.
Hemphill, C. S., & Sampat, B. N. (2012). Evergreening, patent challenges, and effective market life in pharmaceuticals. Journal of health economics, 31(2), 327-339. https://doi.org/10.1016/j.jhealeco.2012.01.004
Kapczynski, A., Park, C., & Sampat, B. (2012). Polymorphs and prodrugs and salts (oh my!): an empirical analysis of “secondary” pharmaceutical patents. PLoS one, 7(12), e49470. https://doi.org/10.1371/journal.pone.0049470
Kesselheim, A. S., Avorn, J., & Sarpatwari, A. (2016). The high cost of prescription drugs in the United States: origins and prospects for reform. JAMA. 2016;316(8):858-871. doi:10.1001/jama.2016.11237
Lenzer, J. (2013). Why we can’t trust clinical guidelines. BMJ, 346. https://doi.org/10.1136/bmj.f3830
Lexchin, J. (2006). Bigger and better: how Pfizer redefined erectile dysfunction. PLoS medicine, 3(4), e132. https://doi.org/10.1371/journal.pmed.0030132
Martín Fernández-Gallardo, AM. (6 junio 2024). La red oscura que las multinacionales farmacéuticas ocultan tras los pagos a profesionales sanitarios: Sus líderes de opinión en el SNS y su red de intereses al descubierto [Internet]. Asociación Acceso Justo al Medicamento, Revista n.º 30. [citado 26 agosto 2024]. Recuperado de: https://accesojustomedicamento.org/la-red-oscura-que-las-multinacionales-farmaceuticas-ocultan-tras-los-pagos-a-profesionales-sanitarios-sus-lideres-de-opinion-en-el-sns-y-su-red-de-intereses-al-descubierto/
Mitchell, A. P., Trivedi, N. U., Gennarelli, R. L., Chimonas, S., Tabatabai, S. M., Goldberg, J., ... & Korenstein, D. (2021). Are financial payments from the pharmaceutical industry associated with physician prescribing? A systematic review. Annals of internal medicine, 174(3), 353-361. https://doi.org/10.7326/M20-5665
Mora, R. M. (2003). La regulación de la visita médica: necesaria pero no suficiente. Atención primaria, 32(10), 562- 563. https://doi.org/10.1016%2FS0212-6567(03)79332-9
Moynihan, R., CG, P., Heath, I., & Henry, D. (2002). Selling sickness: the pharmaceutical industry and disease mongering Commentary: Medicalisation of risk factors. BMJ, 324(7342), 886-891. https://doi.org/10.1136/bmj.324.7342.886
Padilla, E. M., Medina, P. S., & Jaramillo, A. R. (2014). Influencia de la comunicación del profesional de la salud en la calidad de la atención a largo plazo. Revista de Calidad Asistencial, 29(3), 135-142. https://doi.org/10.1016/j. cali.2013.11.007
Participación del paciente en la toma de decisiones. Infac [Internet] 2014 [citado 2024 Ago 29]; 22(3). Disponible en: https://www.euskadi.eus/contenidos/informacion/cevime_infac_2014a/es_def/adjuntos/INFAC_Vol_22_n_3_ Decisiones_compartidas.pdf
Real Academia Española. Diccionario de la lengua española [Internet]. 23.ª ed. Madrid: RAE; ©2024 [citado 26 agosto 2024]. Disponible en: https://dle.rae.es/lobby
Rusz, C. M., Ősz, B. E., Jîtcă, G., Miklos, A., Bătrînu, M. G., & Imre, S. (2021). Off-label medication: from a simple concept to complex practical aspects. International journal of environmental research and public health, 18(19), 10447. https://doi.org/10.3390/ijerph18191044 7
Sackett, D. L., Rosenberg, W. M., Gray, J. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn't. BMJ, 312(7023), 71-72. https://doi.org/10.1136/bmj.312.7023.71
Sayed, A., Ross, J. S., Mandrola, J., Lehmann, L. S., & Foy, A. J. (2024). Industry payments to US physicians by specialty and product type. JAMA, 331(15):1325-1327. doi:10.1001/jama.2024.1989
Schiff, G. D., Galanter, W. L., Duhig, J., Lodolce, A. E., Koronkowski, M. J., & Lambert, B. L. (2011). Principles of conservative prescribing. Archives of internal medicine, 171(16), 1433-1440. doi:10.1001/archinternmed.2011.256
Spielmans, G. I., & Parry, P. I. (2010). From evidence-based medicine to marketing-based medicine: evidence from internal industry documents. Journal of Bioethical Inquiry, 7, 13-29. https://doi.org/10.1007/s11673-010-9208-8
Statista. Top lobbying industries in the U.S. [Internet]. 2024 [citado 2024 Ago 26]. Disponible en: https://www.statista.com/statistics/257364/top-lobbying-industries-in-the-us/
Tenni, B., Moir, H. V., Townsend, B., Kilic, B., Farrell, A. M., Keegel, T., & Gleeson, D. (2022). What is the impact of intellectual property rules on access to medicines? A systematic review. Globalization and health, 18(1), 40. https://doi.org/10.1186/s12992-022-00826-4
Thomas, J. R. (2010). Pharmaceutical Patent Litigation Settlements: Implications for Competition and Innovation. Georgetown Law Faculty Publications and Other Works. 574. https://scholarship.law.georgetown.edu/facpub/574
Van De Vrande, V., Subramanian, A. M., Lévesque, M., & Klopf, P. (2024). The interdependent influence of lobbying and intellectual capital on new drug development. Research Policy, 53(2):104938. https://doi.org/10.1016/j.respol.2023.104938
Wazana, A. (2000). Physicians and the pharmaceutical industry: is a gift ever just a gift?. Jama, 283(3), 373-380. doi:10.1001/jama.283.3.373
World Health Organization. (2018). A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals (No. WHO/HIS/SDS/2018.15).World Health Organization. https://www.who.int/publications/i/item/WHO-HIS-SDS-2018.15
Zamarriego, J., Cabero, L., Usandizaga, R., Abel, F., Cabrillo, E., del Carmen Cuadrado, M., ... & Lozano, B. (2006). La relación entre el médico y las industrias farmacéutica y de productos de tecnología sanitaria. Visión ética (I). Progresos de Obstetricia y Ginecología, 49(9), 512-522. https://acortar.link/mKv7WF
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