Medical guidelines must not be influenced by commercial interests.

Abstract

United European Gastroenterology (UEG; https://ueg.eu/), the united and trusted voice of European gastroenterology, notes with great concern that one of our member societies has been drawn into an international brand and license conflict between competing financial interests in relation to a clinical practice guideline that inter alia had evaluated the use of a specific product in patient care. Our member society was urged to modify their evidence-based medical guideline and to remove any reference to the product in question from the guideline. Medical guidelines play a crucial role in guiding healthcare professionals' decisions and practices, and the recommendations provided with these guidelines often have significant implications for patient care and outcomes. Therefore, it is vital that such guidelines are developed based solely on the best available evidence and are free from the influence of any commercial interests. When guidelines are influenced by commercial interests, such as those of pharmaceutical companies, medical device manufacturers, or other stakeholders, their recommendations may be biased and may not prioritize patients' best interests, leading to recommendations that prioritize financial gain over patient outcomes. This can lead to inappropriate use or overuse of certain treatments, technologies, or medications that may not be necessary or appropriate and can result in patient harm, including adverse effects and complications, unnecessary healthcare costs, healthcare waste and inefficiencies. When commercial interests influence medical guidelines, it can be challenging to determine the true motivations behind the recommendations. This can erode public trust in the healthcare system and lead to skepticism about medical advice. Therefore, medical associations should transparently report funding sources that support the development of their guidelines, and they should not accept commercial sponsorship for medical guidelines.1 Commercial interests need to be distinguished from conflicts of interest of individual medical experts involved in developing guidelines. Individual experts may have personal conflicts of interest, such as financial ties to pharmaceutical companies or medical device manufacturers, which can compromise their impartiality and objectivity. Individual conflicts of interest are defined as circumstances that create a risk that professional judgment or action related to a primary interest will be inappropriately influenced by a secondary interest.1-4 Such potential conflicts of interest of individual medical experts do not represent any commercial links to the medical association sponsoring the guidelines. Conflicts of interest are not negative per se. They manifest themselves through the coexistence of primary interests (e.g., in the case of guideline authors, the formulation of evidence- and consensus-based recommendations to improve the quality of care) and secondary interests (e.g., direct and indirect financial, academic, clinical, personal) whose degrees of expression and significance can vary. Thus, conflicts of interest are often unavoidable but not necessarily problematic in terms of influencing guideline content. Transparency and fair and reasonable handling of conflicts of interest of individual experts are decisive for the legitimacy and credibility of guidelines.5 The declaration of interests and transparent description of the handling of conflicts of interest serve to create trust and protect against speculation about biases. By ensuring that medical guidelines are developed independently of commercial interests, one can ensure that the recommendations are based solely on scientific evidence and expert consensus, rather than any financial or other vested interests. This helps to promote the highest standards of patient care and helps healthcare professionals to make optimal decisions for their patients based on the best available evidence. Ultimately, this can improve patient outcomes and enhance public trust in the healthcare system. In conclusion, commercial influences on medical guidelines can have significant negative impacts on patient care and outcomes, healthcare costs, and public trust in the healthcare system. Therefore, it is crucial to ensure that medical guidelines are developed independently of commercial interests and are based solely on the best available scientific evidence and expert consensus. Data sharing is not applicable to this article as no new data were created or analyzed in this study.