How come the perception that Italians have of the ISF is that of little consideration if not of total negativity?
“Citizens today have a negative perception that makes the relationship between the real and the perceived asymmetrical: a “black” asymmetry that levels it downwards. Once upon a time, journalists carried the infamous three s (sex-blood-money) in their pockets. Today the most important one is establishing itself: Healthcare, almost always told not for cases of excellence in the clinical and research fields, but for news stories that tickle people's negative emotions, fear, distrust, isolation.
The ISF falls into this ambit and is always portrayed as a corrupter, engaged in shady dealings. It is clear that the journalist cannot give up the right to report, but neither can he stick to the medical bulletin, that is, to an institutional version of the news that everyone agrees on. Today, however, the perception of the ISF is one of the problems of health communication, a difficult sector that should be supported by a lot of professional training and knowledge. For a certain journalism what matters is the emotion, the lynching of the executioner, the speculator on health, the jackal who profits from diseases. Today there is ease of interpretation, little control over the news and uncontrollable speed of the media, but above all little knowledge of the role that the ISF should have and still have.
And then the real actor in this professional short-circuit emerges: the demotion of the ISF. And if there is no qualification or there is no proportion between qualification and job, the result can only be disastrous.
All applicable laws qualify the ISF in its true role: it does not and must not have commercial value. The reason is quite intuitive and obvious. Instead, everything is being done to demote it to a pure sales tool and what is serious is that even the unions do not understand this error and agree to include it in the CCNL as a salesman. They don't realize that if the ISF (or rather the former ISF) has to make money on the sale of drugs, it will do everything to expand pharmaceutical spending, with all due respect to ethics.
A model can come to us from France where the government has forced pharmaceutical companies to guarantee the good practice of scientific information by involving doctors in its control. In France, a control body is set up which will choose a panel of doctors (a sort of sentinel doctors), not known to the companies and the ISFs, who will have the purpose of "measuring the quality of promotional practices, based on objective criteria, verifiable and transparent”. Accompanied visits (by an Area Manager) are forbidden, the use of samples of medicines is forbidden and the specialties of competing companies cannot be denigrated. Violators will be severely fined.
Will it ever happen in Italy too? It would be enough for us that the laws in force were followed and that those responsible really check that they are applied. Journalists, in their very important role, should defend these positions.
The reality is that everything is silent, journalists shoot news only for comparison cases accusing the ISF (they should understand that it almost never depends on them), the companies silently demote the role of the ISF to a pure salesman, the unions, ignoring the problem, accept the business point of view. The law is there, but it's as if it didn't exist, nobody checks it. In the most complicit silence the "seller of medicines" comes to life
By now, then, there are also numerically fewer ISFs. Pharmaceutical companies have noticed that general practitioners count less and less from a prescribing point of view: those who decide the prescriptions are the pharmacists as regards generics, the various AUSLs which indicate what must be prescribed and give cash rewards to the doctors who they prescribe less or punish those who prescribe more, specialists and hospitals.
The ISFs, due to the increasingly marginal role of general practitioners, serve less and less pharmaceutical companies which understand the ISFs only as sales promoters and not as scientific information. Hence the dismissal of 15,000 ISF from 2007 to today, and it's not over yet!
The real corruption is at a higher level, below, the real ISFs have almost disappeared: there are a large number of sellers who are called ISFs whose only purpose is to sell in order to survive.
All in absolute indifference to the laws and in the indifference of those who should check that they are respected. Every now and then, a corruption phenomenon emerges and who is to blame? Obviously to the ISF. Whoever does this is obviously completely ignorant of how things work, blames the ISF and that's it. The ISF is the real scapegoat, the sacrificial lamb to allow the real corruptors and the truly corrupt to continue their illicit activities peacefully.
By Redazione Fedaiisf.it – 27/04/2016
Related news: France. A new statute to regulate the activity of Scientific Informers
Southern Italy: first for corruption in Healthcare
Note: The activity of the ISFs was first regulated by Legislative Decree 541/92 implemented and then incorporated into Legislative Decree 219/06. The law (art. 122.6 of Legislative Decree 219/06) states that the ISF depends on a Scientific Service, not on marketing or sales and the ISF themselves must report to the pharmacovigilance service. The Scientific Service is obligatory (art. 126) for every company that holds a marketing authorisation. The relationship of the ISF with the pharmacist is limited to the information contained in the summary of the characteristics of the medicinal product (art. 121). Basically the ISF is not a seller. In support of the provisions of the law there is the authoritative opinion of Prof. Nello Martini, AIFA Director (predecessor of the current one) (AIFA. Clarifications on ISF https://www.fedaiisf.it/wp-content/uploads/2014/12/AIFA.Chiarimenti-su-ISF.pdf ) and the sentence of the Cassation in which it is reiterated that the ISF is not and cannot be a commercial representative agent https://www.fedaiisf.it/non-agente-commercio-linformatore-scientifico/ .
