the Information Gap
Note: This commentary is a modified extract from the paper: "Navigating
the Minefield: Obtaining Reimbursement for Prescription Medicines"
that was published in the Provincial Reimbursement Advisor, IMS
Health, November,1998. Send comments to firstname.lastname@example.org
it could be organised appropriately, the single entity that all
parties: health care providers, payers and health care supply companies
have in common is information. The mutual generation, interpretation
and use of information among these parties currently does not exist.
their respective ways all parties involved in the policy process
have a need for the same information at varying times in their budget
or business cycles. No party wants to be seen having to make decisions
on the basis of bad information.
reasoning and insight that is derived from the timely analysis and
interpretation of reliable information, along with established practice
knowledge, is what drives good health policy formulation.
challenge for all health care supply companies is to differentiate
between participation in policy formulation and conducting a marketing
public policy process is more concerned with the sharing of information
among people who "need to know". In the private sector
this "need to know" can be in conflict with preventing
the competition from finding out.
ministries are inundated with information, Figure 1. Government
officials are exposed to the "high gloss" style traditionally
favoured by the pharmaceutical companies. As noted the media influences
any single health policy issue it may choose to address.
public policy information that is generated within government and
by its various advisory bodies tends to be more formal and in a
more digestible, briefing paper, style.
illustrated in Figure 1, a spectrum of credibility exists between
the creative "high gloss" approach of the marketing and
advertising companies and more neutral, low-keyed, referenced presentation
that is associated with professional public administration and academia.
the court of public policy formulation the information that is being
used must submit to a credibility measure as illustrated in Figure
1. The councils that are responsible for advising government on
public policy must feel comfortable with the level of truth that
can be ascribed to any information they are reviewing.
forums generate and receive information via a medium that complies
with public administration and academic disciplines. Therefore,
the message has to be brief, relevant, reliable and readable to
comply with the public administration / academic part of the truth
spectrum in Figure 6.
in the message being relayed is given when it is acknowledged as
being supported by peer review publications and / or some form of
empirical evidence. Such documentation serve to deliver pertinent
information that allows the recipient to ask pointed questions or
accept the interpretation presented as being valid.
plain, low-key, objectivity of such medium is directly opposite
to the "high gloss" sales approach that is more closely
identified with pharmaceutical companies.
intent here not to say that the "high gloss" marketing
approach has no place in health policy. If more marketing skills
were prominent in health policy implementation it is likely that
fewer teenage women would be smoking, Canadians would be eating
healthier and personal fitness would be more fashionable.
physicians have demonstrated a high rate of compliance in responding
to such medium, it may be more successful in bringing about desirable
changes in this population than publishing bureaucratic looking
prescribing and treatment guidelines.
can be argued that our public policy infrastructure could benefit
from applying the "high gloss" style of to promote favorable
behavior modifications among the public and within the health care
further information see discussion deck
Navigating a Minefield.