"Preventing the disclosure of doctors' identities in the event of expenditure report disclosure and strengthening supervision of CSOs"
Both the pharmaceutical industry and the medical and legal sectors have expressed concerns about defamation, loss of trust in doctors, and the activation of illicit rebates.
With the impending implementation of the expenditure report disclosure system, criticisms have been raised by the pharmaceutical, medical, and legal sectors. The Korea Pharmaceutical and Bio-Pharma Manufacturers Association (KPBMA) recently organized the 2023 KPBMA Ethics Management Workshop during the first half of the year, focusing on "How to Prepare for the Expenditure Report Disclosure System."
On this day, participants expressed their stance, stating that it is necessary to prevent the disclosure of doctors' identities, which could lead to patient mistrust and defamation issues, while also establishing measures to resolve disputes. Additionally, they emphasized the need to strengthen supervision over Contract Sales Organizations (CSOs).
Kang Han-cheol, Attorney at Law, from Kim & Chang presented on the issues surrounding the expenditure report disclosure system and the potential legal disputes.
Mr. Kang remarked, "Although providing economic benefits is a lawful matter, there is a negative perception underlying it, which raises the potential issue of personal information infringement and defamation if doctors' identities are disclosed. Even with anonymization measures, it is still possible to deduce sufficiently based on certain medical institutions and partial information."
Furthermore, Mr. Kang stated, "Under the U.S. Sunshine Act, there is a one-month period for doctors to review the expenditure reports and raise objections, and only the finalized data is disclosed. Although South Korea has the right to request corrections, the operational guidelines have not been determined yet." He added, "It is necessary to establish a dispute resolution platform within the Health Insurance Review and Assessment Service (HIRA) system and build sufficient objection periods and dispute resolution measures."
In addition, he urged the need to explore measures to enhance public awareness so that unnecessary misunderstandings and costs do not arise, considering that this is a nationwide public disclosure system. He also emphasized the importance of establishing measures to prevent any potential side effects.
The pharmaceutical industry also expressed concerns about potential privacy breaches and business disruptions resulting from the disclosure of doctors' identities. Above all, they were apprehensive about the possibility of an escalation in illegal verbal rebates, which could create a ballooning effect. Pharmaceutical companies that properly report their expenditures would become subject to increased supervision, while doctors may be reluctant to establish relationships with such companies, potentially leading to an expansion of illicit rebates through outsourcing of Contract Sales Organization (CSO).
Therefore, if this system is to be implemented, it was emphasized that it is crucial to establish management and punitive measures for CSOs to minimize any adverse effects.
Doctors also raised concerns that the implementation of such a system could potentially portray them as lawbreakers or an immoral group, with the resulting harm ultimately affecting the general public. Professor Eun Baek-rin from Godaekuro Hospital (Director of Academic Promotion, Korean Medical Association) stated, "The biggest problem arises when patients lose trust in prescribed medications due to their association with expenditure reports. This leads to a significant decline in treatment effectiveness."
In response to these concerns, the Ministry of Health and Welfare announced that, as the process of establishing the system is still ongoing, they will make efforts to incorporate and reflect the concerns raised today as much as possible.