Weekend Reading Recommendations

Ready for the weekend? I have these article on my reading list: perhaps you, too, may enjoy some food for thought on some of the hottest topics in the fields of law and innovation:

  • A Layered Model for AI Governance”: https://cyber.harvard.edu/node/100108, on governance for artificial intelligence aimed at ensuring transparency and accountability and addressing massive information asymmetries between the developers of artificial intelligence systems and consumers and policymakers;

 

 

 

Whatever you will be reading, have a great weekend!

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Presentation on GDPR and scientific research at the Paperless Lab Academy

Paola Sangiovanni will be speaking at the Paperless Lab Academy event (http://www.paperlesslabacademy.com/) on March 20, 2018 in Baveno (NO), Italy, on the topic of the impact of the new GDPR for science.

Sofie van der Meulen, Senior Supervision Officer at Dutch Data Protection Authority, will offer a special introduction titled “Why Privacy Matters”.

This promises to be an interesting event. See you there!

 

 

New Rules on Continuing Medical Education

The rules on continuing medical education (“CME”) have changed since a new agreement between the Italian government, the Italian Regions and the autonomous provinces of Trento and Bolzano has come into force on February 2, 2018. You may find the new agreement here or here (only in Italian, sorry).

The agreement is an “upgraded version” of the previous principles, which remain largely unchanged, but are now better defined, stricter and hopefully more effective.

  • THE RIGHT TO CME. Health care professionals (“HCPs”) have the right to obtaining CME and regulators will need to remove impediments in order to allow the exercise of such right.
  • ACCREDITATION OF PROVIDERS. As before, providers of CME need to be accredited, but accreditation will be subject to stricter rules, which particularly focus on avoiding any conflicts of interest. Providers will also need to adopt an internal regulation setting forth how to prevent and exclude (even potential) conflicts of interest.
  • SPONSORSHIP OF EVENTS. Sponsorship of CME events will be possible by private companies, provided that the principles of transparency, objectivity, impartiality and independence are complied with. No advertisement of medicinal products or medical devices can be carried out during the CME event, but only before, after and outside the event. No direct payments or reimbursements are allowed to speakers or moderators of the CME events.
  • NO ACCESS TO PERSONAL DATA OF HCPs. On the data protection front, note that sponsors of CME cannot have access to lists and addresses of participants, speakers or moderators.
  • SPONSORSHIP OF HCPs. Lastly, HCPs may be sponsored by commercial firms operating in the health industry, but cannot fulfil more than one third of their CME requirement through such sponsorship. This is bound to change how CME has been handled before, forcing HCPs to bear the cost of at least two thirds of their CME requirements.

Have a great weekend!

Vaccines: the Italian Constitutional Court rules in favor of mandatory vaccination imposed by national law

The polarized debate over vaccines sees the Italian Constitutional Court taking an important step into the discussion, shortly before the last notable rebellion against compulsory vaccination in Italy. Only a few days ago, in fact, the Mayor of Rome, Ms. Raggi (together with the members her Council, unanimously), approved a motion contradicting the mandatory nature of the 10 (originally 12) vaccinations, made compulsory for school-age children by a recently enacted Italian law. Nevertheless, the “rebels” in Rome probably did not take into the appropriate account the decision of the Italian Constitutional Court, which ruled in favor of the vaccines imposition under Italian law.

The Court – in deciding a constitutional challenge brought by the Veneto Region against the imposition of vaccination by the State – explains its views in a straightforward way.

First of all, the Court makes it very clear that, when it comes to vaccines, fundamental health care rights are involved and, to such regard, no difference is constitutionally acceptable between different areas of the Italian territory. In other words, when a healthcare measure is imposed by a national law in the public interest, Regions and local authorities do not have a say about it.

Furthermore, and most importantly, the Court clarifies that – also taking into account the worrisome drop in vaccination rates in recent years – the choice of tightening up legislation to compel vaccinations is not unreasonable.

True, persuasive techniques – such as the ones that Veneto Region would like to implement – can, ideally, represent a better option, but only when the herd immunity result is somehow guaranteed. Conversely, when vaccination rates drop, obligations and sanctions by law – as the California example showed – are not only reasonable (and constitutional), but much more effective.

Well, when the going gets tough, the law gets going. And that’s reasonable, Italian Constitutional Court says.

Take our Quiz on the New MoH Guidelines on Medical Device Advertisement!

On December 20, 2017, the Italian Ministry of Health has issued interesting guidelines on medical device advertisement to the general public, which you can download here (scroll to the bottom of the page).

The new rules describe DOs and DONTs in advertisement on Instagram, YouTube and Facebook and offer interesting indications on the use of a celebrity in the ads.

The basic principle remains the same: advertisement of medical devices that are subject to medical prescription (or may be used only with the assistance of medical personnel) is prohibited by Italian law. When allowed, advertisement of medical devices to the public is subject to authorization by the Ministry of Health.

Take our medical device advertisement quiz to check if you know (or can guess!) what’s new in the guidelines!

  • Can a doctor recommend a medical device in an advertisement to the general public?

No, the Ministry of Health will not authorize such advertisement.

  • What about a celebrity appearing in an advertisement message?

While the mere presence of such individual may be tolerated, no express or implied endorsement of the medical device will be authorized.

  • Can authorized medical advertisement be shared through Instagram?

Yes, but only in the “Stories” section and if users’ comments are de-activated.

  • What about Facebook?

As comments cannot be de-activated, a special disclaimer must be used in order to clarify that the Ministry of Health authorization of advertisement solely covers advertisement, while any further comments are the responsibility of users.

  • Is a medical device company allowed to email advertisement to patients?

Yes, but only if the Ministry of Health has authorized the advertisement and if the patient has expressed his/her consent (always revocable).

Holiday Reading Selection

Dear Readers and Friends,

With Christmas and Boxing days behind, you should have had your share of party time with your family and friends (if not, New Year’s is a good time to catch up).

If you are ready for some quiet time to read some interesting articles in the areas of innovation, health and the law, here is a selection of holiday reading that our life sciences group has prepared for you.

We wish you a 2018 filled with good health, great technology and interesting law!

Warm wishes from

Paola Sangiovanni, Flavio Monfrini, Marco Bertucci and Miriam Postiglione

a.k.a. the GITTI and Partners life sciences team.

**********************************************************************************

New Whistleblowing Legislation Approved in Italy

Whistleblowers will be granted a higher level of protection under new legislation passed earlier this week in Italy.

The new provisions apply to civil servants as well as employees in the private sector. Whistleblowing protection will shield individuals who submit a good faith report concerning unlawful conduct, provided that such report is based on a reasonable belief and factual elements.

The new legislation prohibits any retaliation or other discriminatory measures against good faith whistleblowers, including termination, demotion, transfer or other organizational action.

In the private sector, the new legislation has a significant impact on organizational models adopted to prevent corporate criminal liability pursuant to Legislative Decree 231 of 2001. In fact, all organizational models will need to set up appropriate channels for the confidential reporting of criminal conduct and violations of the organizational models themselves.  Measures aimed at protecting the identity of the whistleblowers and the confidentiality of the reports, as well as disciplinary sanctions against retaliatory or discriminatory measures against whistleblowers, will also need to be included in such organizational models.

The new legislation is expected to enter into force shortly, upon publication in the official gazette.

New crimes triggering criminal corporate liability introduced.

Starting from November 19, 2017 and following an amendment of the Anti-Mafia Code, additional criminal conducts will trigger corporate criminal liability pursuant to Legislative Decree no. 231 of 2001. (If you are not yet familiar with “231”, i.e., the Italian law setting forth criminal corporate liability, you may refer to our previous blog post for an overview of such legislation).

Section 25-duodecies of Legislative Decree no. 231 of 2001 has been amended by the introduction of three new paragraphs (1-bis, 1-ter and 1-quater) relating to the following crimes in the area of illegal immigration:

• Procured illegal entry into the State; and
• Favoring illegal permanence into the State.

The full list of crimes and sanctions can be found here.

The idea is to punish companies who take advantage of illegal immigration, as well as to provide an incentive to companies to organize their activities in order to prevent such corporate crimes (in fact, companies are exempt from liability if they set up and actively pursue organizational models aimed at preventing corporate crimes). It is, however, unclear if continuously increasing the list of crimes that companies must prevent is an efficient way to do that.

G7 Health Summit Closed Today in Milan

On November 5 and 6 the G7 Ministerial Meeting on Health was held in Milan. The meeting had an ambitious agenda, ranging from the impact of climate change on people’s health to antibiotic resistance.

According to the Italian Ministry of Health, hosting the summit on the occasion of the 2017 Italian G7 presidency, the meeting innovated in the way matters have been examined and discussed, by using a so called Delphi method based on the opinions of the world’s leading experts.

A number of satellite events have also taken place across the city, including a conference organized by police forces to address the cross-border fight against “pharmaceutical crime” in all its forms, identifying the critical factors and common responses. The conference focused on the strategies and international collaborations needed to crack down on counterfeit pharmaceutical products, as well as the import and on-line sales of unauthorized products.

Another satellite event focused on the employment of new technologies in the healthcare sector, with particular emphasis on sustainability. Antibiotic resistance has also been a key item on the agenda. Italy is among the countries in the world where deaths linked to antibiotic resistance are higher.

Italian authorities did not conceal that one of the hidden goals of the summit was for them to lobby for the relocation of the European Medicines Agency- EMA headquarters to Milan. The political battle among candidate cities is about to get more intense, as a decision is expected to be adopted before the end of November.

More information on the agenda and materials of the summit can be found here: http://www.g7italy.it/en.

Clinical Trials in Italy: Changes Announced.

On October 25, 2017 the lower chamber of the Italian Parliament (Camera dei Deputati) has approved a bill, which – inter alia – promises to change how clinical trials of pharmaceuticals are regulated by national law.  The bill requires that the changes follow these directions:

  • Requirements for trial centers will be issued and monitored yearly;
  • There will be greater involvement of patients’ associations in the protocol definition, especially in areas of rare diseases;
  • The name of the authorized trial centers, as well as of names and curricula vitae of all subjects involved in clinical trials, of the relevant financing arrangements and the relating contracts, will be published;
  • Measures aimed at protecting the independence of clinical trials and the absence of conflict of interests will be strengthened;
  • Minimum contents of clinical trial agreements will be set forth;
  • Formal requirements for the requests of opinions to the Ethical Committees will be simplified;
  • The possibility to use biologic or clinical residual material from previous diagnostic or therapeutic activities, under whichever title possessed, for clinical research purposes (subject to the patient’s informed consent) will be made easier;
  • Proceeds arising from clinical trials will be allocated between the trial center and research funds managed by the Ministry of Health;
  • Sanctions for breaches of legislation will be rationalized (and will include suspension of Ethical Committees, who breach procedures or miss deadlines).

According to the bill, the following changes would instead affect independent or non-profit clinical research, which in Italy continues to be based on a Ministerial Decree of 2004:

  • Revision of legislation in order to facilitate non-profit and observational clinical studies;
  • Private companies, who support such studies, will be allowed to purchase the relating data and use them for registration purposes.

The road to an actual change of legislation is still tortuous, as it requires a favorable vote of the exact same bill by the Senate, as well as a governmental legislative decree that would set forth detailed regulations along the aforementioned directions. Surely it is too early to predict the results of any such change.

In any event, given the room that EU Regulation 536/2014 still leaves to Member States’ legislation and how generic, old and fraught with issues the current Italian legislative framework is, reforming Italian clinical trial legislation is definitely a good idea.