The Economic Implications of the Relationship between Pharmacy and Psychiatry in Lithuanian 2001-2020: The Problem of Biomedical Access

Abstract

Although previous research in Lithuania has indicated the construction of the diagnosis and treatment of mental illness through historical and cultural chapters, a considerable amount of research has been published in foreign literature that has emphasized the role of the pharmaceutical industry in diagnosing and treating mental illness. In this paper we examine the relationship between the pharmaceutical industry (pharmaceutical and medical device manufacturing companies), healthcare professionals and healthcare organizations in the mental health field. The relationship between the pharmaceutical industry (pharmaceutical and medical devices manufacturing companies) and healthcare professionals can be analyzed in two ways: research-oriented interactions and promotion practices. This relationship is inevitable and can be beneficial, however, conflicts of interest arise, which create a risk of potential harm to users and patients (e.g. as receiving suboptimal or unsuitable treatment, or waste of private and public money). This research analyzes both the relationship between the diagnosis and treatment of mental illness and the pharmaceutical industry market in Lithuania in 2010-2020, as well as the efforts of Lithuanian health care institutions in restructuring the mental health care system. Based on the analysis of the literature and statistical data, we state that after the restoration of independence, the main method of mental health treatment in Lithuania is still medical treatment, i.e., patients with mental illnesses and behavioral disorders are treated with medication. The main factors determining the still dominant method of medical treatment of mental illness are the following: first of all, the Soviet legacy (the paradigm of medical treatment - the Soviet paradigm); secondly, the restoration of independence in our country has created excellent conditions for Western pharmaceutical companies to develop their activities and increase sales of medicines, including psychotropic drugs; and third, medical treatment is cheaper for the state than complex treatment. This study draws on an analysis of the social origins of mental illness, while reviewing the previously unappreciated role of the interests of pharmaceutical companies in expanding their markets for the treatment of mental illness with drugs.