Independence between employees in the health sector and pharmaceutical industry
Danish regions have adopted guidelines to promote stronger independence between employees in the health sector and the pharmaceutical industry at the regional level.
The commitment targets the relatively specific policy area of public-private relations in the health sector and is therefore deemed specific.
The commitment identifies the clear, measurable action of establishing guidelines regarding interactions between employees in the public health sector and the pharmaceutical industry, which can be measured binarily as fulfilled/not fulfilled.
Four out of five regions have responded to our inquiry on developments since 2018, with regards to strengthening independence between the health sector and the pharmaceutical industry. All four regions have signed an individual collaboration agreement with the Danish Pharmaceutical Industry Association (LIF). The regions state that the agreement focuses on “the fact that no doubt can be raised about the impartiality of the employees”. The agreements all contain guidelines for private companies’ financial support to public employees’ continuous education. More specifically, hospital management must now approve and select the employees who participate in specific training and education offered by private companies. Furthermore, each region has done their own specific work to further their commitments. For example, the Capital region has, since 2018, allocated additional resources to ensure the continuing medical education of employees, while both the Capital and Zealand regions report that employee participation in advisory boards must now be approved at management level. However, both the Southern Denmark and the Central regions have focused on strengthening the dialogue with the pharmaceutical industry to evaluate their guidelines, which does not ensure independence and could lead to deeper and potentially harmful collaboration. Lastly, Zealand region has strengthened the rules on side jobs and business missions by ensuring that the content and scope of external cooperation relations are coordinated in advance, thereby avoiding potential conflicts of competence and interests.
Challenges to effective commitment implementation
The fact that the Danish regions have signed individual agreements with LIF could prove to be a challenge as employees travelling between regions would not necessarily work under the same conditions where they have their relationship with the medical industry.
It is recommended that the guidelines adopted by Danish regions are standardised across all regions to clarify the framework of cooperation with the medical industry.