Corruption. But why is it always the fault of the ISF?

How come the perception that Italians have of the ISF is that of little consideration if not of total negativity?

“Il cittadino oggi ha una percezione negativa che rende asimmetrico il rapporto tra il reale e il percepito: un’asimmetria “nera” che livella verso il basso. Una volta i giornalisti portavano in tasca le famigerate tre s (sesso-sangue-soldi). Oggi si sta imponendo quella più importante: la Sanità, quasi sempre raccontata non per i casi di eccellenza in ambito clinico e di ricerca, ma per fatti di cronaca che solleticano le emozioni negative della gente, la paura, la sfiducia, l’isolamento.

L’ISF rientra in questo ambito ed è sempre descritto come un corruttore, dedito a loschi affari. E’ chiaro che il giornalista non può rinunciare al diritto di cronaca, ma nemmeno attenersi al bollettino medico, cioè ad una versione istituzionale della notizia che metta d’accordo tutti. Oggi però il percepito dell’ISF è uno dei problemi della comunicazione sulla salute, un settore difficile che dovrebbe essere sostenuto da molta formazione professionale e conoscenza. Per un certo giornalismo ciò che conta è l’emozione, il linciaggio del carnefice, lo speculatore sulla salute, lo sciacallo che lucra sulle malattie. Oggi c’è facilità di interpretazione, poco controllo sulle notizie e velocità incontrollabile dei mezzi di comunicazione, ma soprattutto poca conoscenza del ruolo che dovrebbero avere e che hanno gli ISF.

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.

Da 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: L’attività degli ISF è stata prima regolamentata dal D.Lgs. 541/92 recepito ed inglobato poi nel D.Lgs. 219/06. La legge (art. 122.6 del D.Lgs. 219/06) dice che l’ISF dipende da un Servizio Scientifico, non dal marketing o vendite e gli stessi ISF devono riferire al sevizio farmacovigilanza. Il Servizio Scientifico è obbligatorio (art. 126) per ogni impresa titolare di AIC. Il rapporto dell’ISF col farmacista è limitato alle informazioni contenute nel riassunto delle caratteristiche del medicinale (art. 121).  In sostanza l’ISF non è un venditore. A conforto del dettato di legge c’è l’autorevole parere del Prof. Nello Martini, Direttore AIFA (predecessore dell’attuale)  (AIFA.Chiarimenti su 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/ .