Dergi Ara >>
Yıl:2008; Cilt: 19; Sayı: 3>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2008;19(3):310-317
Tanıtım Kaynaklı Etik Sorunlara Yönelik Bir Öneri: Ulusal İlaç Bilgi Ağı
M Civaner
Uludağ Ü. Tıp Fak Deontoloji ABD, Bursa
İlaç şirketlerinin tanıtım çalışmaları, sağlık çalışanlarının ve kamuoyunun gündemine giderek sık biçimde girmektedir. Çeşitli kaynaklarda tanıtım etkinliklerinin etik sorunlara yol açabildiği, akılcı ilaç seçimini engelleyebildiği, hasta-hekim ilişkisini ve mesleği olumsuz etkilediği, ayrıca maliyetleri artırdığı ileri sürülmektedir. Günümüzde sağlık çalışanlarının ilaçlar hakkındaki bilgilerini büyük oranda ilaç şirketlerinden edindikleri göz önüne alındığında, sözü edilen sorunların önemli boyutlarda olduğu ve etkin girişimlerde bulunulması gerektiği görülmektedir. Bu sorunların önlenmesi için sağlık çalışanlarının eğitilmesi, ilaç şirketleriyle ilişkilerde nasıl tutum alınması gerektiği üzerine yol gösterici meslek ahlakı kılavuzları yayımlanması, şirketlerin iş ahlakına yönelik düzenlemeleri yaşama geçirmesi gibi girişimler önerilmektedir. Bununla birlikte, yapılan araştırmalar, sözü edilen girişimlerden sadece pazarlama yöntemleri hakkındaki eğitimlerin ve devlet düzenlemelerinin etkin olduğunu ortaya koymuştur.

Bu makalede, var olan durum tanımlandıktan sonra, tanıtım etkinliklerinin olumsuz etkilerini azaltmak ve akılcı ilaç seçimini sağlayabilmek için ulusal bir bilgi ağı kurulması önerilmektedir. Dünya Sağlık Örgütü, akılcı ilacı, "en etkin, en güvenli, en kolay uygulanır ve en uygun maliyetli ilaç" biçiminde tanımlamaktadır. Bu ölçütleri dikkate alarak ve kanıta-dayalı bilgileri kullanarak hazırlanacak ve güncellenecek bilgileri, ülke çapında tüm sağlık çalışanlarına eşit, hızlı ve kolay erişilebilir biçimde ulaştıracak bir bilgi ağı, tanıtım çalışmalarının olumsuz etkilerini azaltabilecek, şirket temsilcilerinin sağlık kurumlarında birebir tanıtıma yönelik etkinliklerini kısıtlayacak kurumsal politikalara destek olacaktır.
A Proposal for the Prevention of Ethical Problems Related to Drug Promotion: A National Network for Drug Information
The promotional activities of pharmaceutical companies are becoming an increasingly hot topic among healthcare workers and the general public. There are many studies in the literature claiming that drug promotion may lead to ethical problems, irrational use of medication, and increased costs, as well as negative effects on the patient-physician relationship and the medical profession. When considering that healthcare workers generally acquire their knowledge from the pharmaceutical industry, the problems mentioned, which are indeed of paramount importante, and the need for effective and sustainable interventions are clearly revealed. Many kinds of interventions have been recommended by various authorities and studies in order to prevent the kinds of problems mentioned above, including training healthcare workers, publishing professional codes to serve as guidelines about which professional values should be protected and how to cope with different situations in relationship to the pharmaceutical industry, or applying the business ethics codes of the pharmaceutical companies. Studies that assessed the effectiveness of different interventions, however, revealed that educating healthcare workers about marketing methods and state regulations are the only effective interventions.

In this article, after defining the problem, a proposed national network for drug information is to decrease the negative effects of drug promotion and to promote the rational choice of medicines is described. According to the World Health Organization, rational use of medicine is the most effective, safe, applicable/suitable, and, lastly, the most cost effective option. A national network that will gather drug information by compiling evidence-based knowledge and taking rational use of medicine measures into account should be established. It should transmit information to all healthcare workers in a fast, equal, up to date, easily accessible, and free way. The network should also support institutional regulations that aim to limit the promotional activities of pharmaceutical companies.

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