[CIPOMO position paper about conflict of interest.]

A substantial part of the final cost of health-related products is due to marketing, and the revenue from sales is, at least in some cases, disproportionally higher than the development costs. In this context, financial interests can add to drug pricing and prevail over healthcare issues and equity of access to services. Conflict of interest (COI) is a «condition in which the professional judgment concerning a primary interest (the health of a patient or the reliability of research results or the impartiality of clinical informations) tends to be unduly influenced by a secondary interest (for example an economic gain or a career advantage)». The potential consequences of COI extend from research to guideline drafting, from teaching to clinical decision making. The contiguity of opposing interests can condition the clinician, either consciously or unconsciously. This conditioning, in turn, can have direct consequences on the quality of the provided services, but can also cause insufficient transparency, or distrust of the Health Service. The College of Italian Medical Oncology Directors (CIPOMO) together with all the stakeholders that contribute to the good functioning of cancer care, issues a list of statements that refer to principles of transparency and ethicality in the use of resources. The following recommendations do not intend to establish rules of conduct. Rather, they have the purpose of contributing to awareness of the nature and potential consequences of COI in the clinical community and of promoting constructive reflection within healthcare organizations.