THE INFLUENCE OF THE ISRAELI LEGISLATION ON THE RELATIONSHIP BETWEEN PHYSICIANS AND PHARMACEUTICAL COMPANIES

INTRODUCTION: The relationship between physicians and pharmaceutical-companies raises many dilemmas. There are two types of solutions to these dilemmas: self-regulation and government regulation. Our goal was to review in what way legislative intervention and self-regulation standardize and affect the relationship. In addition, we examined the positions of relevant stakeholders regarding: 1. The relationship between physicians and pharmaceutical companies; 2. Future measures we should take to address the ethical dilemmas inherent in this relationship.

METHODS: 1. In-depth interviews with 42 senior representatives of all the relevant stakeholders, with emphasis on their organizational identity, since their points of view are influenced and shaped by organizational and professional positioning. We analyzed the interviews using the Narralizer program. 2. Analysis of three databases: The Ministry of Health, The Israel Medical Association and Pharma-Israel, regarding donations made to various parties in the health system.

RESULTS: The influence of Israeli legislation on the relationship between physicians and pharmaceutical companies is almost imperceptible. However, in recent years, there have been changes in this relationship stemming from international self-regulation, which leads to: contractual relationships, decreases in hospitality and tighter internal control over this relationship.

CONCLUSIONS: Regulation in Israel is not achieving its goal satisfactorily. Solutions to reduce the influence of this relationship exist. However, the first step is for the regulator to decide to what extent, if any, he wants to deal with this issue. If the regulator chooses to take the lead on this issue, we will soon face additional legislation that might limit the amount of money that the pharmaceutical companies can donate to healthcare organizations.