It is important that healthcare stakeholders, such as research institutes, healthcare professionals and patient and carer organizations, have access to up-to-date information on diseases and treatments while safeguarding their independence at the same time.
Our approach to interacting with health systems
We support health systems by collaborating with our healthcare stakeholders, such as professional medical associations, patient and carer organizations, university clinics and other institutions that provide healthcare. We follow clearly defined internal approval requirements and procedures for each type of interaction, in line with applicable laws and codes. In countries with statutory or industry obligations on the disclosure of transfers of value to healthcare stakeholders, we aim to comply with these obligations.
We are committed to adhering to all regulations concerning the promotion of pharmaceutical products. In most markets, pharmaceutical companies are permitted to advertise prescription medicines only to healthcare professionals, such as physicians and pharmacists. These promotional activities must always disclose the active ingredient, potential adverse effects and contraindications of the medicine. Our aim is to apply high ethical standards. Our internal governance documents on the promotion of pharmaceutical products are part of our Group-wide healthcare program, which requires us to conduct business in compliance with the law and industry obligations. We regularly review all our internal governance documents and revise them as required in response to any new developments.
We clearly differentiate between information-sharing activities and promotional activities. The former are activities where we share scientific information but have no intention of promoting or increasing the sales of pharmaceutical products. The latter are activities with a clear intention to promote or increase sales of pharmaceutical products. The differentiation is critical for various internal policies and standard operating procedures, responsible functions, and levels of review and approval.
In some countries we inform consumers directly. For example, in the United States direct-to-consumer (DTC) advertising for prescription medicines is permitted. In line with applicable local laws, we use DTC advertising in these countries to help increase people’s awareness of certain diseases and the available therapies. In doing so, we aim to empower patients to make informed decisions about their own treatment.
Roles and responsibilities
For all interactions with healthcare stakeholders, we have established internal policies and review processes and tools, such as record-keeping systems. Thereby, we want to ensure adherence to statutory requirements and transparency obligations.
Our Global Regulatory Affairs unit has established a dedicated standard and corresponding process document on the review and approval of our promotional materials for our Healthcare business sector. At the operational level, the relevant business and all employees involved in our sales and marketing activities must adhere to our internal policies, standards and procedures.
To ensure that all promotional materials meet our standards as well as local regulations end-to-end, we apply a harmonized Group-wide review and approval system. In our Healthcare business sector, we use a single global software tool. This has enabled us to unify, simplify and monitor the review and approval process for promotional materials and monitor that process in accordance with the dual-control principle. If the material has promotional intent and is product-related, a review is conducted by our Medical, Legal and Regulatory functions. This also helps us identify opportunities for improvement. All employees involved in creating, reviewing and approving promotional materials undergo training on the current process for reviewing, approving and decommissioning promotional materials based on our principles and standards.
Our commitment: Group-wide guidelines and industry standards
In addition to applicable laws and our own internal standards, we also strive to comply with the codes of conduct of various international industry organizations, such as the Code of Practice published by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) and the Code of Practice of the European Federation of Pharmaceutical Industries and Associations (EFPIA).
We are also members of various local industry associations, such as the German Association of Voluntary Self-Regulation for the Pharmaceutical Industry (FSA) and the U.S. Pharmaceutical Research and Manufacturers of America (PhRMA). Our activities are aligned with the associations’ codes for collaboration between healthcare professionals and the pharmaceutical industry.
Our Group-wide Pharma Code for Conducting Pharmaceutical Business and Pharmaceutical Operations (Pharma Code) defines the general compliance for our activities in the Healthcare sector. It provides high-level and overarching principles that govern our interactions with physicians, medical institutions, and patient and carer organizations, along with our promotional practices.
Our Healthcare Ethical Guiding Principles supplement the Pharma Code and guide our Healthcare employees with six ethical principles for decisions and activities specific to the particular challenges and responsibilities of this business sector.
Under the umbrella of our Pharma Code and Healthcare Ethical Guiding Principles, we have specific governance documents, procedures and tools for different types of interactions with healthcare stakeholders, covering topics such as service engagements, hospitality, payments (at fair market value), donations and sponsorships to participate in events.
Our Standard on Medical Activities provides the general principles and requirements that must be respected in all medical activities, including interactions with healthcare providers. The specific governance for the different types of activities and interactions is detailed in further policies and standards, standard operational procedures and other governance documents.
Collaborating with patient and carer organizations
We seek to improve patients’ quality of life, which is why we support the work of patient and carer organizations. In turn, these organizations provide patients, family members and caregivers with information on disease management as well as educational and advocacy resources.
Our Policy on Interactions with Patients, Patient Opinion Leaders and Patient Organizations provides a comprehensive framework for our interactions with these key stakeholders. Our guideline entitled Good Practice and Process Guidance: Engagement with Patients, Patient Opinion Leaders and Patient Organizations provides additional guidance for our interactions with these stakeholders. It reflects our commitment to prioritizing patient well-being and guides appropriate patient/caregiver engagement that enables our patient-directed approach. Through this policy, the supplementary guideline and specific local policies, we provide a robust guidance structure to support our employees in remaining compliant throughout their interactions with patients, patient opinion leaders and patient organizations.
Supporting medical education
To contribute to medical advances that benefit patients, we support non-promotional medical education programs worldwide by funding independent third-party medical education providers including medical societies and academic organizations. We also organize company-led medical education programs. We take an ethical, transparent and responsible approach, providing fair and balanced content that allows the expression of a diverse range of theories and recognized opinions.
All requests for independent medical education funding are subject to an approval process through our R&D and Compliance functions, in line with our Standard on Medical Education Funding. This process ensures all funds granted for medical education programs comply with our internal guidelines and criteria as well as all applicable laws and industry codes.
In addition, we partner with industry associations, such as the Global Alliance for Medical Education (GAME) and the International Alliance for Continuing Medical Education (iPACME). We are also an active member of the relevant working groups established by the European Federation of Pharmaceutical Industries and Associations (EFPIA) and the Medical Affairs Professional Society (MAPS). Together with these associations, we discuss ways to harmonize and improve quality standards for medical education.
Transparent reporting
We publish the financial and non-financial contributions we make to healthcare stakeholders in the healthcare industry, such as healthcare professionals and healthcare organizations, as appropriate and in accordance with local laws and codes. The published information includes the names of individual recipients, their addresses, the purpose, and the contributed amount or value as required by the applicable laws and codes. In addition, before publishing, we secure all necessary informed consent forms, as required by the applicable data privacy regulations.
In addition to disclosing monetary transfers of value on an individual level, we continue to publish overall spending on our research and development activities, as required.
Apart from disclosing transfers of value to healthcare professionals and healthcare organizations as required, we ensure transparency on our voluntary unsolicited donations to European patient organizations by publishing the contribution details on our website. The report is updated annually and includes all amounts, recipients and the purpose of each transfer of value, thus also meeting our obligation as an EFPIA member.
Regular employee training
In 2023, we continued our Code of Conduct training curriculum on managing dilemmas in sector-specific situations. This comprehensive and interactive training course seeks to improve participants’ awareness and understanding of relevant dilemmas, such as overhearing a conversation that may or may not constitute attempted bribery. The training program was successfully implemented in all countries in which our Healthcare business sector operates.
Moreover, employees who are responsible for the promotion of our pharmaceutical products receive regular training on current guidelines. This applies to individuals in sales, marketing and functions that work directly with healthcare providers. We conduct these seminars either locally in a classroom setting or as e-learning courses.
Depending on their roles and responsibilities, new employees participate in onboarding training dealing with the review and approval of promotional materials. Additionally, employees in charge of marketing and promotion of pharmaceutical products can also access our respective guidelines on our corporate intranet.
Based on their roles and responsibilities and in order to remain up-to-date, employees participate in mandatory e-learning courses and classroom training on our policies and guidelines as well as important changes to the reporting requirements for transfers of value.