Forging the Future of Healthcare: The US Consensus Framework for Ethical Collaboration
In an initiative to establish a more ethical, equitable, and collaborative healthcare system in the United States, leading healthcare stakeholders came together to create the US Consensus Framework (USCF). The framework was established in 2023, guided by the collaborative efforts of various US healthcare organizations, including medical associations, patient groups, and life sciences entities.
The National Health Council (NHC), the National Medical Association (NMA), and the Pharmaceutical Research & Manufacturers of America (PhRMA) launched the USCF, which is meant to serve as a forum for stakeholders in the health care system, with the ongoing addition of key stakeholders, focused on establishing best practices and standards centered on the needs of patients and the promotion of health equity.
The Reason Behind the Framework
The United States is known for its advanced healthcare capabilities, yet it faces significant challenges such as structural, racial, environmental, and financial barriers, that hinder equitable access to healthcare. Furthermore, the burden of medical debt continues to affect a vast segment of the population, compounding disparities in healthcare access and quality. The USCF was crafted to address these pressing issues by fostering strong ethical collaboration across the healthcare ecosystem, positioning patients at the core of healthcare discussions and innovation and improving overall health outcomes.
To help address concerns around health access, affordability, equity, and putting patients at the center of the health care industry, involved stakeholders aim for the document to be a “foundation for a more inclusive and comprehensive consensus framework that is increasingly capable of addressing the evolving needs of both today’s and tomorrow’s patients.”
The Framework
The framework takes inspiration from the International Consensus Framework for Ethical Collaboration, initially established by six global healthcare organizations including the International Alliance of Patients’ Organizations (IAPO), the International Council of Nurses (ICN), the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the International Pharmaceutical Federation (FIP), the World Medical Association (WMA), and the International Hospital Federation (IHF).
Founding principles of the USCF are:
- Put Patients First
- Support Ethical Research and Innovation
- Promote Transparency and Accountability
- Ensure Independence and Ethical Conduct
Recognizing that healthcare challenges evolve, the USCF is designed as a living document. It is open for ongoing review and updates to remain relevant and responsive to new healthcare advancements, technologies, and the changing landscape of healthcare needs.
By embodying values of respect, equity, trust, collaboration, and innovation, the US Consensus Framework aims to transform the healthcare system into one that not only meets but exceeds the needs of all patients, setting a new standard for excellence in healthcare. This initiative serves as an open invitation for all healthcare stakeholders in the US to join in this ethical collaboration, ensuring a better health system for future generations.
Put Patients First
Under this priority, the USCF emphasizes the importance of collaborating with patients and other health care stakeholders to improve access to health care and address barriers to optimal health.
Support Ethical Research and Innovation
Under this priority, the USCF encourages clinical and related research to generate information about safe, effective, and appropriate use of health treatments to reflect the diversity of the United States population. This includes not just ensuring that research involving human subjects has a legitimate scientific purpose, but also ensuring that it is sensitive to the needs, historical health experiences, and values of diverse populations. Additionally, trials should be accessible to people in diverse situations and participants should be informed about the nature and purpose of the research.
Promote Transparency and Accountability
The USCF notes the importance of trust between the health care industry and the public, starting with “appropriate transparency and accountability in our individual and collaborative activities.” This includes ensuring that all arrangements that require financial compensation for services not only have a legitimate purpose but also have a written contract in place prior to the start of services, with remuneration not to exceed an appropriate amount.
Ensure Independence and Ethical Conduct
The USCF states that interactions should always be ethical, appropriate, and professional. This includes restrictions on gifts, stating, “nothing should be offered to patients or by or between healthcare professionals, healthcare entities, or life sciences companies in a manner or on conditions that would have an inappropriate influence.”
Statements from Foundational Stakeholders
“This framework is essential to help guide partnerships that enable meaningful and appropriate patient engagement. Without patient involvement from the beginning, the effort to bring effective treatments to market and promote high-quality care is missing a critical voice – the patient. The National Health Council endorses this Framework for Ethical Collaboration to ensure patients are at the center of our health system,” said Randall L. Rutta, Chief Executive Officer, National Health Council.
“As the voice of Black health, the National Medical Association strives to both advance the art and science of medicine for people of African descent and support efforts towards improving the quality and availability of healthcare to underserved populations across the country. The USCF provides the platform and opportunity to advance health equity to the forefront of US healthcare discussions and sets the standard for ethical, patient-centered collaborations,” said Joy D. Calloway, Executive Director, National Medical Association.
“Since the inception of the PhRMA Code more than 20 years ago, PhRMA member companies have demonstrated their commitment to upholding the highest standards of business ethics and compliance. Our members’ robust ethics and compliance programs serve as the gold standard worldwide. This Consensus Framework is a historic step to build on this foundation, allowing leading health system stakeholders to partner and continue to drive thought leadership and forward progress in business ethics and equity. Today’s announcement is just the first step, and we look forward to building on this important partnership in the months ahead,” said Stephen J. Ubl, President and Chief Executive Officer, Pharmaceutical Researchers & Manufacturers Association.