Undue Influence of Pharmaceutical Companies' Marketing Incentives on Healthcare Providers

Name and Constituency of Member of Parliament
Mr Gerald Giam Yean Song
MP for Aljunied GRC

Question No. 476

To ask the Minister for Health (a) how does the Ministry ensure that healthcare providers (HCPs) are not unduly influenced by pharmaceutical companies' marketing efforts or incentives when recommending or prescribing drugs to their patients; (b) whether the Ministry monitors compliance with the Singapore Association of Pharmaceutical Industries (SAPI) Code of Conduct; (c) whether there have been any violations of this Code of Conduct and (d) whether the Ministry will consider introducing a centralised reporting system for pharmaceutical companies' payments and transfers of value to HCP

Written Answer

Healthcare professionals are required under professional standards to act in the interest of their patients and not be unduly influenced by such third parties. For example, in the Singapore Medical Council’s (SMC) Ethical Code and Ethical Guidelines (ECEG), where financial interests or business relationships compete with a doctor’s professional duty towards patients, the doctor must prioritise the patients’ interests and not let business and financial considerations influence the objectivity of their clinical judgement. 

Larger healthcare institutions, such as hospitals, institute organisational policies relating to sponsorships from and relationships with pharmaceutical companies, to ensure that employees maintain the highest standard of integrity, retain clinical objectivity in patient care, and are transparent in their conduct. MOH and its Statutory Boards have similar governance frameworks to safeguard against conflicts of interest for healthcare professionals. 

In addition, Pharmaceutical companies work within the Singapore Association of Pharmaceutical Industries (SAPI) to promote ethical practices and self-regulation amongst its members through their acceptance and adherence to the SAPI code of conduct. SAPI also updates healthcare professionals, institutions and associations on significant changes to the code, and seeks their support to implement these changes. SAPI is a private association, and MOH does not monitor compliance to the SAPI Code and does not have information regarding violations of the code. 

Safe and appropriate prescribing of medication without undue influence requires effective collaboration between MOH healthcare professionals, institutions and industry associations. To that end, MOH has been working with our licensed healthcare institutions to develop an agreed set of common best practices to guide healthcare institutions in accepting external sponsorships. These guidelines will first be implemented in our public healthcare institutions in the first quarter of 2021, and will eventually be converted to a Code of Practice that applies to both the public and private healthcare sectors.

Given these efforts, MOH is not currently considering a centralised reporting system for pharmaceutical companies’ payments and transfers of value to healthcare professionals. Instead, we will continue to work with healthcare institutions to ensure that their employees act in accordance with professional obligations and organisational policies. We welcome any feedback on improper practices and such reports will be investigated accordingly.