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Corruption Risks in the Healthcare Marketplace: Why Transparency is the Right Medicine

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Focuses on the need to tackle corruption in medicines marketplace.

Focuses on the need to tackle corruption in medicines marketplace.

Published in: Health & Medicine, Business

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  • 1. www.transparency.org Corruption Risks in the Healthcare Marketplace: Why Transparency is the Right Medicine Robin Hodess Director of Policy and Research Transparency International [email_address] MeTA International Advisory Group Meeting London, UK – 16 September 2008
  • 2. Why focus on corruption and health ? Corruption undermines achievement of human development priority Corruption puts lives at risk
  • 3. What are the scale and impact of corruption in the healthcare marketplace? USA: Fraud and abuse costs $11.9 – 23.2 billion/year Costa Rica: $9 million skimmed off Finnish loan by head of health insurance Ghana: 80% non-salary funds ‘leak’ between central govt and district Philippines: 10% increase in corruption reduces immunisation rate by 10-20% UK: losses to patient fraud were $305m in 1999; $139m in 2004 Uganda: Leakage rate for drugs and supplies at 70%, according to 2006 study Kyrgyzstan: 50% patients paid informal payments in 1996; one third borrowed money/sold livestock Peru: nearly 15 tons of fake medicines seized What are the scale and impact of corruption in the healthcare marketplace?
  • 4. What creates corruption risk in health systems?
    • Uncertainty
    • High levels of public spending
    • Complexity of systems: multiple stakeholder and decision points
    • Government regulation
    • Competing objectives: commercial v. health
    • Imbalance of information
  • 5. Corruption risks in the selection and delivery of pharmaceutical products
    • Registration
    • Selection
    • Procurement
    • Distribution
    • Service Delivery
  • 6. Addressing corruption: Why transparency?
    • Transparency supports public accountability
    • Transparency leads to less corruption
    • Transparency is in the interest of private companies and corporations
    • Transparency supports effective market regulation leading to lower pricing
    • Transparency is vital to promote equitable access to medicine
  • 7. Critical areas of transparency in the healthcare marketplace
    • Regulatory policies
    • Price
    • Quality
    • Quantity
    • Procurement data
  • 8. Transparent solutions…
    • Harmonised regulation
    • Transparency of information
    • Greater access of information on drug and clinical trials
    • Reporting financial contributions made to medical research
    • Implementing and publicising standards on how to avoid conflicts of interest
    • Strengthening marketing and promotion codes
    • Public commitment and reporting on anti-bribery programmes
  • 9. Transparency " plus " : What else can be done?
    • Integrity pacts for major procurement agencies in the health sector
    • Civil society participation in hospital boards, open forums and public oversight of procurement and drug selection
    • Whistleblower protection for health sector workers
    • Other measures: enforceable codes of conduct, decent wages for health workers, r igorous prosecution of counterfeit drugs producers, etc.
  • 10. The challenges of transparency
    • Reliability and accuracy of data
    • Reporting compliance
    • Reporting standards
    • Transparency and access to information are not enough
  • 11. Return to transparency
    • Less corruption
    • Accountability
    • Business case
    • Equity and accessibility: the right to health
  • 12. www.transparency.org Robin Hodess Director of Policy and Research Transparency International [email_address] MeTA International Advisory Group Meeting London, UK – 16 September 2008