What's the ideal relationship between the drug industry, health professionals and patients?

The relationship between the drug industry, academia, healthcare professionals, and patients is widely believed to be at an all time low. Five contrasting views, published on bmj.com today, discuss what the ideal relationship should be and what steps need to be taken to achieve it.

Marcia Angell, Senior Lecturer in Social Medicine at Harvard Medical School believes there should be no relationship between the drug industry and either prescribers or patients.

The purpose of the drug companies' contact with prescribers is nearly always to increase sales, and it usually involves payments of one form or another, she writes. These are often disguised as education, but the real intent is to influence prescribing habits. Likewise, direct to consumer advertising seeks to convince people that they have a chronic treatable medical condition. "We need to stop accepting the fiction that marketing, whether to precribers or patients, is good education", she concludes.

But others believe that there is a legitimate place for responsible collaboration.

Professors, Harlan Krumholz and Joseph Ross propose six standards of conduct to restore public trust. These include dispensing with direct to consumer advertising, foregoing gifts, and stopping industry sponsorship of continuing medical education. "Leading companies and physicians have already taken many of these steps to promote the best care for patients - it's time for the rest to follow," they write.

Richard Tiner, Medical Director at the Association of the British Pharmaceutical Industry says that the UK industry is committed to a stable and pragmatic partnership with the government and the NHS on medicines - one that enshrines value for money, reward for innovation, and ensures greater availability of new medicines to patients.

While Gordon Coutts, Vice President and General Manager at Schering Plough UK believes that joint working has the potential to create breakthroughs in how the UK tackles major health challenges including cardiovascular disease and teenage pregnancies.

Finally, Scott Gottlieb, a health policy analyst based in Washington DC, suggests that the industry should build trust based on good science rather than marketing related activities. Drug makers need to establish transparent guidelines for interactions with doctors and patients … and focus more squarely on matters of advancing science, monitoring for safety, and improving health education, he writes.

Source: British Medical Journal

   

• VOR - Feb 04, 2009
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  translation(cynical): market drugs more covertly. While generally a good system, there are a few big areas where capitalism stands in direct opposition to the public good. Its completely obvious that making drugs for profit will always put profit ahead of health. But in our collective lunacy we continue to ignore this while pretending and hopelessly wishing that somehow this system will magically correct itself and let profits take a backseat to health. Financial pressure to market drugs sustains behavior sometimes counter to public health. Not only in 'pushing' drugs, but in neglecting preventive medicine (you all know why). Only fundamental change (not just regulation) to a social model that puts health first, and eliminates pressure and temptation to market drugs inappropriately, can bring the right drugs to everyone at a fair price and not overmedicate us.
  The political challenges, ignorance and opposition to such ideas do not make them any less valid. This is not an endorsement of socialism. It's a statement of fact that in order best serve the public good capitalism must have a few (more) areas that are socialized. Healthcare (and drugs) is one of those few areas.
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• E_L_Earnhardt - Feb 05, 2009
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  RIGHT ON VOR! THE PRETENSE OF CARING IS AWFULLY THIN!
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