The debate in the EU about Information to Patients rumbles on. It raises some interesting questions about the strategies of patient groups and the Pharma industry across a wider range of issues.
The battle lines on ITP can be clearly drawn. Opposed sit most national governments, health professionals, and the health insurance industry. Favourable are patient groups and the Pharma industry.
The opposition has prevented progress for a number of years. The lessons are instructive.
Within the opposition, each stakeholder has a commercial or political interest in less, not more ITP. The insurance industry are opposed for obvious reasons; doctors are opposed because they believe it will open channels of information which do not involve them; governments are opposed because as payers they worry about the impact on healthcare costs.
Yet these groups have outmanoeuvred those in support. They have to a large extent avoided public discussion of their real motivation, by focusing on the threat of a slippery slope towards US-style advertising. From the earliest skirmishes, they have been able to frame the debate, and those in favour of ITP have been on the back foot.
Against such a coalition of interests, the Pharma industry and patient groups need to avoid being pulled apart. Yet this is precisely what has happened, because the opposition chose the frame of the argument. Because of the loss of trust in the Pharma industry, patient groups are worried about being seen too closely associated. This means the resources of those in favour have never been successfully marshalled.
Strong, clear interventions from patient groups can yet win the day, particularly if they encourage more public discussion on the motivations of governments, and put the advertising threat in context.
The ITP case study can be a learning experience for patient groups and the Pharma industry more generally. This type of game will be played out more and more, with governments winning, unless they do something to change the framing. The groups and the industry can allow themselves to accept the characterisation imposed by others and maintain low levels of trust, or they can operate how many others do with aligned interests, and create clearer operating rules that build trust and allow necessary levels of co-operation to achieve influence.