Experience of the public disclosure of payments to healthcare professionals (HCPs) in the Netherlands shows that it starts with good working relationships and mutual trust. That is the conclusion that has been drawn after the introduction of the Transparency Register in the Netherlands in 2013, in which the financial relations between healthcare professionals and the pharmaceutical industry are disclosed.
Every citizen can verify online if his or her HCP is involved in activities working with pharmaceutical companies and if so, in what kind of activities. The creation of the Register was relatively easy, as all the stakeholders knew each other well when talks about its creation started. For many years – since 1998 to be exact – the Dutch organization of innovative pharmaceutical companies – Nefarma has worked together with organizations of doctors, pharmacists, generic and OTC drug companies in the “Foundation for the Code for Pharmaceutical Advertising” or as we call it in Dutch – the CGR. This is the body that controls the rules on marketing and promotion, through self regulation. (In this context, advertising is defined as any form of influencing with the aim of endorsing the prescription, supply or use of medicinal products. This not only covers promoting medicinal products, but also stimulating their prescription or supply by awarding, offering or promising benefits in cash or in kind.) This long-term collaboration through the CGR, based on mutual trust even when interests are sometimes conflicting, was a key success factor.
As it became clear that society in Holland wanted more openness about the payments by companies, a sentiment strongly expressed by our former Minister of Health, Nefarma started talks with the HCPs within the CGR. Although there was some reluctance at the beginning, all parties convinced their members that self-regulation was the preferred route to deliver greater transparency. That made the creation of the register a relatively simple process. The biggest challenge was to convince the Dutch Authority that oversees the privacy of Dutch people, i.e. the doctors involved to ensure the information could be legally disclosed. As a consequence the Transparency Register is linked to the official register of all health care professionals. To be honest, that makes the use of the register a bit more complicated than we should have wished. Nonetheless, it gave us the possibility to disclose the relationships and be the first in the world to achieve this through self-regulation.
The Transparency Register was introduced in April 2013 during a press meeting by representatives of the industry, government and doctors, showing shared opinions about the value of being open. In 2014 11.000 unique visitors consulted the register.
The initiative was welcomed by Dutch politicians, media and society. They all recognized the wish of companies and HCPs working together in the benefits of patients in an open and transparent way.