Ban money and gifts from drug and device makers to health workers, and pay for their learning through a public fund
In short
- Drug and medical device companies can no longer give doctors and nurses money, meals, or trips.
- Companies stop paying health workers to give talks and stop holding their own study sessions.
- Companies pay part of their sales into a public fund, and the fund pays for health workers to keep learning.
- Medical societies that write treatment guidelines and patient groups also stop taking money directly from companies.
- Health workers who break the rules lose their licenses for a time, and companies pay fines based on the size of their sales.
If this comes true
In a clinic in the mountains, a young doctor does what they learned in a fund-supported course: for a farming grandmother's aching back, they suggest an old, cheap medicine and exercises instead of an expensive new drug, and the family has one less money worry.
Perhaps
In a hospital in a low-wage country, a doctor who got by on company speaking fees may no longer be able to make a living and might leave to work abroad.
Water so far 💧 0
The proposal in detail
The rule covers companies that make or sell goods whose sales depend on what health workers recommend, such as drugs, medical devices, test kits, infant formula, and health foods. The people and groups who cannot receive money are licensed doctors, dentists, pharmacists, and nurses, medical students, the hospital departments that handle buying and prescribing, the medical societies that write treatment guidelines, the groups that train health workers, and patient groups. What is banned is cash, gifts, meals, travel costs, speaking fees, pay as an adviser, and invitations to training or society events paid for by a company. In its place, each company pays a small, fixed share of its domestic sales into a fund that is independent of both the government and the industry. The fund hands out money for courses that help health workers keep learning, for writing guidelines, for the work of patient groups, and for sharing fair comparison information about new drugs, and it keeps separate which company paid how much and who received what. There are two exceptions. One is real clinical research, allowed only when the plan is posted in a public register and a contract with fixed unit prices is made through a go-between such as the fund. The other is safety information: companies send side effects and instructions for use to a public contact point, where anyone can see them. Sales representatives are no longer allowed to visit health workers one by one to promote products. A health worker who breaks the rules has their license suspended for a set period, a company pays a fine based on its sales, and the fines go into the fund. Payments across borders, and workarounds through subsidiaries or advertising firms, are treated the same way.
BenefitsPrescriptions follow patients' benefit, not sales
Because the flow of money itself is cut off, health workers have no reason to feel they owe a company, and it becomes easier to choose a drug by its effect, its price, and the patient's life alone. Unlike a disclosure rule, this makes accepting the money impossible, so it also reaches the workings of the mind that tilt preferences without anyone noticing. Companies keep paying for learning through the fund, so training for health workers does not suddenly vanish; its content turns into comparison information that does not lean toward any one product. As a result, old, cheap, reliable drugs get a second look, overuse of painkillers, antibiotics, and drugs for the mind is expected to fall, and medical costs for society and for households can be kept down. Medical societies that write guidelines and patient groups no longer have to watch the faces of companies, so trust in the guidelines grows, and patient groups can more easily speak up about what is truly needed. For companies too, there is no longer any need to spend money on a race of sales entertainment, and they can turn their effort toward competing on how good their drugs really are. Trust in medicine is the foundation that supports treatment in every field.
DrawbacksHealth workers' income and the flow of information shrink
Health workers who have relied on company thank-you payments and speaking fees, especially doctors in low-wage countries and regions, will see their income fall noticeably. There is a risk that more of them will take money from patients under the table, quit their jobs, or go abroad to fill the gap. Society meetings will get smaller, and there will be fewer places where health workers gather to learn from one another. In remote areas, news of new drugs that sales representatives used to carry may arrive late, and it may take longer for patients who need a new drug to start using it. Patient groups will have to wait for the fund's allocations, and there is a worry that groups for rare diseases with few patients will be put off until last. The line between a research contract and a thank-you payment is hard to draw, and even honest joint research might be chilled by troublesome paperwork. Company influence will not disappear; it may move to online voices, direct advertising to patients, and hard-to-see payments routed through other countries, and the side that enforces the rules will need a great deal of effort and money. The share paid into the fund may also be added a little to the price of drugs.
Learn the background
In every country, what a doctor prescribes, which device they use, and which formula they recommend to a mother can mean a great deal of profit or loss for the company selling it. So companies have sent money to health workers in the form of meals, trips, speaking fees, and research funds, and have also paid for the activities of the medical societies that write treatment guidelines and of patient groups. It has been reported again and again that even small gifts change prescriptions, and the same root can be seen across fields: too many painkiller narcotics, too many antibiotics, switching to expensive new drugs that work only slightly better, and a trend of recommending formula over breast milk. Those who lose out are the patients, who bear the harm and cost of unneeded drugs, and the society that pays the bills. Rules that make payments public have spread, but even with disclosure, not many fewer people accepted the money. Most health workers believe they are not influenced, medical societies cannot hold their meetings without sponsor money, and public budgets have hardly paid for health workers to keep learning. In low-wage countries, thank-you payments from companies have become part of people's livelihoods. Because everyone seems to gain, little force for change arises from inside.
Choose them ready to accept their drawbacks too (up to 5)
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This proposal was written in Japanese by AI (claude-opus-5-5, policy version 2026-10-28a) and translated by AI (claude-sonnet-5-5). Nobody has checked the facts. Read the original (日本語) How the AI writes