From a patients' point of view, what is your assessment of the G10 process and the review of the EU's pharmaceuticals legislation?
I believe we made quite good progress considering the diversity of interests represented around the G10 table. From my point of view the most important issue was the recognition that there is a clear distinction between patient information and direct-to-consumer advertising of prescription-only medicines. The G10 Task Force agreed that the ban on direct-to-consumer advertising of prescription-only medicines should continue. But we also called for a Europe-wide initiative to ensure that patients have access to good quality, balanced information about diseases and treatment options. We want to see the establishment of a public-private partnership involving all relevant stakeholders - patient groups, health professionals, member states, regulatory bodies, industry and the European Commission - to develop and independent information source or gateway for patients and to ensure that the information conforms to recognized quality standards.
There is no reason why the pharmaceutical industry should not contribute to this partnership alongside other stakeholders, and indeed they should be encouraged to do so, but it is very important that they do not become the sole providers of information about medicines. Informed patient participation in healthcare choices is impossible without access to accurate, comprehensive, unbiased information about the pros and cons of all available treatment options, including the option of no treatment. This type of information cannot be conveyed through advertising, which aims, by definition, to sell a particular product. Many pharmaceutical companies have invested in 'disease awareness' campaigns via television or websites. These can be helpful if they are not overly alarmist and they comply with quality principles, but they are not helpful if they are simply a disguised attempt to advertise one or more products.
Can you comment on important health topics at EU level, in particular, on the increased mobility of patients and healthcare professionals in the EU-25. What opportunities / drawbacks do you see in this trend?
While travel across country boundaries for healthcare appears to be an increasing trend, I believe the vast majority of European patients will continue to want to receive healthcare as near to their homes as possible. Those that do travel may want to compare the quality of health facilities in different countries, pointing to a need for standardized ways of making comparisons. The European Commission should try to reach a consensus on key quality indicators and to ensure they are published in an accessible form so that patients can make use of them. This might also help to raise quality standards in healthcare throughout the EU area.
Mobility of health professionals is an important issue as many European countries face shortages among some types of healthcare staff. Greater mobility will benefit patients and professionals alike, but it will be important to ensure that all staff can communicate well in the local languages because good communication is highly valued by patients.
Information to patients - the issue of what kind of information and the ways in which this information should be provided to patients have been the subject of long-running discussions. What are your views on this?
See above. Insufficient information about their illness, prognosis and treatment options is central to people's dissatisfaction with healthcare. It comes top of the list of problems identified in patient surveys and is the underlying cause of the vast majority of formal complaints and legal actions. So it is very important to get this right. Good quality patient information should include the following elements: use patients' questions as the starting point; address common concerns and mi sconceptions; refer to all relevant treatment options; include honest information about benefits and harms; quantify outcome probabilities wherever possible; include check lists and questions to ask the doctor; include sources of further information; pay attention to principles of good design; use non-alarmist, non-patronizing language; be explicit about authorship and sponsorship; include reference to sources and strength of evidence; include the publication date.
The WHO recently adopted a global strategy on the fight against obesity. What more could the EU do in your view to advance the fight against this '21st century epidemic'?
Stronger regulation of advertising of unhealthy foods to children should be a priority, coupled with better food labeling.
What are the emerging health threats for which the EU should prepare?
The greatest threat to world health is poverty and ignorance. The EU should increase its aid and technical assistance to Africa and ensure that this is targeted at the poorest people in these countries.
Some say that the EU should be given more powers on public health. Would there be added benefits for patients if the EU's powers were increased?
Before seeking to extend its powers in public health the EU should carefully consider the health impact of its existing policies and powers, for example the Common Agricultural Policy. A critical appraisal of these from a health perspective would probably reveal instances where health is harmed as a result of EU policy instead of promoted and protected. These anomalies and contradictions need to be sorted out before trying to strengthen the EU's powers to intervene in public health issues.
Angela Coulter spoke to EurActiv on the occasion of a stakeholder conference assessing the outcome of G10 medicines process, entitled "A Stronger European-based Pharmaceutical Industry for the Benefit of the Patient" (see also
EEurActiv 9 June 2004).
