We have already discussed the need to insulate from industry influence organizations that have some ability to persuade prescribers (e.g., medical schools).  The need for firewalls is even stronger in areas where an organization has formal legal or regulatory power to shape prescribing. The Federation of State Medical Board’s eventual decision to stop accepting funding from the pharmaceutical and medical device industry was a positive step and should be uniformly adopted by USA state and Canadian provincial medical boards. 

   Prohibitions against industry influence in this arena are justifiable entirely because of concerns about protecting patients. But it bears considering that such rules also protect prescribers who practice ethically and compassionately. Just like patients, physicians have a right to expect that the rules under which prescribing is conducted were set based on scientific evidence and intended solely to benefit patients, not to enrich industry.

   Finally, the Commission notes that the spate of multi-billion dollar lawsuits surrounding the opioid crisis in the United States can also create conflicts of interest. The restrictions on regulatory bodies proposed in this recommendation should apply not only to material connections to the pharmaceutical industry, but also to law firms suing some element of the industry and individuals hired as expert witnesses by those firms.