The Pharmaceutical Journal
Vol 270 No 7246 p570-571
26 April 2003

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Letters to the Editor

Industry and Journals

Who is hijacking whom?

From Dr R. J. Harman, MRPharmS

I was dismayed by the anecdotal attack on the pharmaceutical industry in your "Masquerade" editorial (PJ, April 12, p498). The least that should have been provided when impugning the integrity of the industry that bears the profession's name is to give examples of supposed wrongdoing to give some credence to the comments. The tone and content of the editorial does not convey the supposedly professional and authoritative voice of pharmacy. The diatribe would have been worthy of a Channel 4 documentary — except it is our professional journal that is being hijacked.

Your editorial accuses those working in the pharmaceutical industry of hijacking messages from other parties to their own — and, implied, unethical — ends. That end is — and woe betide anyone seeking to do so — to produce a profit. Never mind that the industry produces helpful and supportive information for users of its products. There is no recognition given of the considerable investment required to generate and run such programmes and the not unimportant contribution that many companies do make to patient support groups, usually overtly. What would be the virtue of hiding the fact that you are trying to further enhance the quality of life of people using your products through such groups?

As an experienced journalist, you must realise that there is no such thing as an "unbiased message". Favourable results from clinical trials are often made public immediately before renewed funding at an academic research establishment has to be secured. Details of poor performance of health professionals are often "buried" under other, better news. True, the pharmaceutical industry is not lily white in its activities, but is it any worse than others at trying to manipulate its message? I would suggest not.

Leaving aside the fact that you have insulted more than 2,000 pharmacists working in the industry, you should perhaps consider your own position in relation to the information that is published about the activities of the Royal Pharmaceutical Society. The PJ publishes comment and "information" from the Society's Officers and members of Council — in effect the PJ is hijacked each week by those following their own agenda. The modernisation of the Council and the proposed change of the Society to charitable status are two such issues on which the PJ "informs" the membership on instruction from the Council. Is that unethical as well?

The case is further undermined when more than two pages of a recent PJ were devoted to reports of drug developments from the American College of Cardiology — and the PJ's attendance was supported by Merck/Schering Plough Pharmaceuticals. Using your yardstick, is that not also unethical? Would the news about latest drug developments have otherwise been reported? I think not.

Is it too much to expect the professional journal of all pharmacists in Britain to support the aims and efforts of the pharmaceutical industry, rather than demeaning and criticising it? Or is this just symptomatic of the continued squeezing out of any other than "active" pharmacists from the consciousness of the profession? Oh, and by the way, I do not represent any vested interest except my own.

Robin Harman
Farnham, Surrey

Altruism is not the sole preserve of The Journal

From Dr H. R. Patel, MRPharmS, MB BCh

One might get the impression from the tone of your leading article entitled "Masquerade" (PJ, 12 April, p498) that the editorial team may have somehow become unwitting victims of some of the "tactics" employed by executives in pharmaceutical companies described in this article.

Could you please clarify which of the very interesting and educational articles appearing in the "News" and "Research and Development" sections of this particular issue represent an example where "innocent parties" are being hijacked by pharmaceutical executives in pursuit of promoting company messages in the guise of "medical education"?

Could it be the educational article reporting new data presented at the American College of Cardiology congress which "slipped in" the name of two products? Highly unlikely given that the editorial team is clearly sensitive to this particular tactic of pharmaceutical executives. Then again, hijacking by the industry may not be an issue in this case, after all the PJ did attend the ACC congress courtesy of Merck/Schering-Plough Pharmaceuticals.

I agree with you that transparency with regard to the funding of medical education sponsored by pharmaceutical companies is indeed the key. In this regard I presume the inclusion of six full pages of product advertisements is an attempt at funding transparency by the PJ.

Further, your editorial suggests that pharmaceutical companies "check" sponsored articles for accuracy before they are submitted for publication. Can the readership, therefore, assume that all product promotions and associated product claims that appear in the PJ are rigorously "checked" by the PJ to ensure that the "message" which comes as part of the package is accurate?

As a pharmacist and pharmaceutical physician I have been closely involved with the pharmaceutical industry in the development of many medical educational programmes which have been of direct benefit to both patients and prescribers. Your editorial does great injustice to many health professionals who work as non-marketing pharmaceutical executives and who are required to "operate" in compliance with the Medicines Act 1968 and the Medicines Act (Advertising) Regulations 1994. The legislation creates criminal offences to which pharmaceutical executives could be liable.

As you are no doubt aware, it is a condition of membership of the Association of the British Pharmaceutical Industry to abide by the Code of Practice which aims to ensure that the promotion of medicines to members of the health professions and to administrative staff in hospitals and health authorities and the like is carried out in a responsible, ethical and professional manner.

Altruism is not the sole preserve of the PJ; like pharmaceutical companies, community pharmacy also has to glean a return on investment and address the "bottom line" and, yes, along the way people's health is improved by both.

Himanshu Patel
Pharmaceutical Medical Consultant
Eastleigh,
Hampshire

Providing information is not a cynical exercise

From Dr J. Patterson, MRCP

Providing information to doctors and pharmacists on the medicines we have discovered and developed is indeed one of the aims of the pharmaceutical industry. But it is not the cynical exercise in manipulation that you seem to think (PJ, 12 April, p498).

Information provided by pharmaceutical companies has to satisfy stringent criteria or it will fall foul of our own rigorously enforced code of practice. Pharmacists, just like doctors, are health care professionals and it would be insulting to them to suggest that they cannot understand that a company wishes to promote its products — of course it does — or to challenge data that are presented in a dubious or inappropriate way.

Furthermore, the pharmaceutical industry does not "use" patient groups to lobby the National Institute for Clinical Excellence, or any other organisation for that matter. Patient groups are very much their own people and any representations will have been made to NICE solely in the best interest of patients and not at the industry's behest.

The fact that we still have postcode prescribing of NICE-recommended medicines happens to give patient groups, the Association of the British Pharmaceutical Industry, and the Secretary of State for Health a common platform.

But we are not "using" Mr Milburn either.

Certainly we would agree with you that transparency is the key to the industry's relationship with patient groups. Guidelines issued by the Long-Term Medical Conditions Alliance — whose vice-chairman made the speech at the ABPI annual dinner referred to in your leader — strongly advise groups to make it crystal clear where their funding comes from.

The ABPI fully endorses those guidelines.

John Patterson
President
Association of the British Pharmaceutical Industry

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