The Pharmaceutical Journal
Vol 270 No 7231 p42
11 January 2003

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JAMA (jama.ama-assn.org)
The Lancet (www.thelancet.com)

Pharmaceutical industry promotions criticised

Promotional activities of pharmaceutical companies have been criticised in articles published in two leading medical journals, the BMJ and The Lancet.

The article published in the BMJ last week (2003;326:45) accuses pharmaceutical companies of "corporate sponsored creation of a disease" — female sexual dysfunction (FSD).

Ray Moynihan, a journalist with the Australian Financial Review, says that the definition and classification of FSD was drawn up at meetings sponsored, run and attended by pharmaceutical companies. A subsequent article in JAMA (1999;281:537 and 1174) reported a total prevalence for FSD of 43 per cent. Mr Moynihan says that this is "a figure now widely cited in both the scientific and lay media" despite questions about the definition and the prevalence.

"The potential risk, in a process so heavily sponsored by drug companies, is that the complex social, personal and physical causes of sexual difficulties — and the range of solutions to them — will be swept away in the rush to diagnose, label and prescribe," Mr Moynihan says.

The article in The Lancet last week (2003;361:27) reports an assessment of advertisements carried in six Spanish medical journals in 1997. Researchers from the Fundación Insitituto de Investigación en Servicios de Salud, Valencia, Spain, led by Dr Pilar Villanueva, found 264 different advertisements for antihypertensives and 23 different ones for lipid-lowering drugs in a six-month period. These made a total of 125 referenced claims. Excluding 23 claims with unpublished data, the researchers say that for 45 of the claims (44 per cent) the literature did not support the statement made.

The most frequent reason for claims being unsupported was that the advertisements recommended the use of drug in a patient group different from that studied in the trial. Other problems included transferring results from high-risk groups to the general patient population, exaggerating trial results or overemphasising their significance, and using animal data to support human use.

The authors say that medicines advertising rules in Spain are covered by the same European directive that applies to the United Kingdom and that extracts from medical journals or scientific papers are required to be truthfully reproduced. They are also critical of the reproduction of images of medical journals such as The Lancet in advertisements "to reinforce the credibility of the product".

In an accompanying editoral (ibid, p10), Dr Robert Fletcher of Harvard Medical School, Boston, cautions readers not to accept claims made in either advertisements or original research uncritically. "Regulation of advertising claims is not strong or consistent enough to protect readers from misinformation," he says.