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BMJ puts industry relations under spotlight

Published on 29/10/03 at 10:20am


Patients would benefit from less involvement between pharmaceutical companies and the medical profession, according to new research.

A study of more than 1,000 GPs in England linked frequent visits by sales representatives to unnecessary prescribing and a greater receptiveness to drug ads and other promotional literature.

GPs that saw sales representatives at least once a week were also more likely to agree to patients' requests to prescribe a drug not clinically indicated, the research said.

The study forms part of a series of articles in this week's British Medical Journal examining how doctors and the industry interact.

Editor Richard Smith said: "Our central argument is that doctors, drug companies, and most importantly patients would all benefit from greater distance between doctors and drug companies".

But the industry has strongly defended current practice, saying information on new drugs is best provided by manufacturers and that the industry's Code of Practice provides safeguards well beyond those laid out in law.

Dr Trevor Jones, Director General of the ABPI, said: "The UK-based pharmaceutical industry strives to maintain the highest possible ethical standards in its dealing with healthcare professionals and other stakeholders".

Although the ABPI was not contacted for comment, the BMJ denied that the issue was intended to be "anti-drug company".

Guest editor for this week's BMJ, Ray Moynihan, said: "We hope this will spark a broad debate about how to clean up the unhealthy aspects of the relationships between doctors and drug companies, at the same time as reinforcing the productive collaborations of discovery".

"But first drug companies have got to learn how to win friends without having to buy them, and doctors have got to learn to value their profession's credibility without having to sell it".

Pharma company payments to doctors are currently the subject of draft guidelines from the World Medical Organisation intended to avoid doctors developing conflicting interests. WMO proposals seek to outlaw payment of travelling or accommodation costs at a conference, or compensation for their time.

The BMJ also criticised pharma-sponsored research as being more likely to favour the sponsor's products and, once completed, to be selectively reported.

Swedish researchers found duplicate and selective publication, and selective reporting of clinical studies in submissions to regulatory authorities for five antidepressant drugs.

The industry was also taken to task for the way it works with patient organisations, with a senior doctor calling for greater transparency in relationships between them.

Dr Andrew Herxheimer of the UK Cochrane Centre wrote: "Most patients' organisations are poor and have little independent funding. Grants and joint projects with pharmaceutical companies can help them grow and be more influential, but can also distort and misrepresent their agendas".

Dr Herxheimer called for relationships to be open and acknowledged and for regulatory authorities to make a distinction between independent patient groups and those receiving extensive funding.

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