Drug companies often lurk behind the scenes

The committee members who decide which medications and medical services the state will fund are not the only ones who get into gear when decision time rolls around. Pharmaceutical companies are sometimes lurking behind the recommendations that physicians associations submit to the committee.

Some companies fund activities for physicians associations or for groups representing patients suffering from a particular disease.

Sometimes, pharmaceutical companies sponsor indirect advertising for prescription drugs, in the form of newspaper articles or ads that don't specifically mention the name of the medication, as it is illegal to advertise them directly.

"The pressures the pharmaceutical companies exert on the health basket committee deliberations are part of the democratic game, and it's legitimate that there are pressure groups for adding various medicines - as long as it stays within reason," said Avinoam Reches, who heads the Israeli Medical Association's ethics board.

The U.S. Congress has passed a law requiring pharmaceutical companies to report any financial contributions made to organizations or specific doctors, with some companies already starting to report their contributions even though the law doesn't go into effect until March 2011.

Israel is working on a similar proposal, initiated by the Israeli Medical Association and Pharma Israel, an association of the Israeli subsidiaries of multinational companies specializing in medical research and development.

"It can't be that the ethical and moral policies of multinational companies in the United States are different from those in Israel," Reches said.