Health Select Committee
The Health Select Committee is appointed by the House of Commons
to examine the expenditure, administration and policy of the Department
of Health and its associated bodies.
Following an inquiry, the committee publishes a report that sets
out its views and usually makes recommendations to the Government.
The Government is expected to respond within two months, setting
out these recommendations as accepted or rejected, with explanatory
notes.
Parliament was dissolved on 11 April. A new select committee will
be set up some weeks after the return of Parliament following the
general election on 5 May. |
Limits should be set on the quantity of promotional material
that prescribers receive, particularly within the first six months of
a product’s
launch. So says the House of Commons Health Select Committee in its report
on the influence of the pharmaceutical industry, published earlier this
month.
“Doctors are deluged with promotional messages following the release of
a new medicine, and nurses and pharmacists will increasingly be so in
the future,” says the report. It suggests that inexperienced doctors
are ill-equipped to cope effectively with promotional material and that
stricter controls are needed regarding the promotion of new products
by drug representatives to these doctors, as well as to pharmacists and
nurses.
Jonathan Underhill, assistant director of education and development at
the National Prescribing Centre, says that although some health care
professionals are good at evaluating information, whether it be promotional
material or journal articles, others are not as critical as they should
be. “People need to become more aware of the tactics that are used
to get a message across, not only by the pharmaceutical industry but
by the media, too,” he says.
He agrees with the committee’s recommendation that the volume of
promotional material is too high. “An information explosion has
occurred and adding to the ‘noise’ of the information that
people are receiving is not helpful,” he says. “At the moment
there is a lot of non-POEM (Patient-Oriented Evidence that Matters) promotional
material out there and a lot of it is either misleading or just adds
to the noise.”
The Association of the British Pharmaceutical Industry believes that
the volume of promotional material given to prescribers following the
launch of a new drug is appropriate. A spokesman for the ABPI comments: “It
is important that health care professionals are aware of what new products
are available on the market to help people with their various conditions.
Obviously the first six months is the most important period so that everyone
is aware of what there is around and can decide if it is appropriate
[to prescribe] for the people they are seeing.” He adds that, compared
with other countries in Europe, the UK has the poorest uptake of new
medicines during their first five years on the market. “Why do
we need to impose more restrictions to push us even further down the
league in the uptake of new medicines which, at least potentially, offer
greater benefits than older medicines,” he asks.
The committee also recommends that consideration should be given to limiting
who can prescribe a drug in the two years following its launch. “Drug
and therapeutics committees would be well placed to implement this,” says
the report. It suggests that prescribing rights could be extended after
evaluation of the value of the product in clinical practice by the Medicines
and Healthcare products Regulatory Agency or the National Institute for
Health and Clinical Excellence.
In the report the committee expresses concern that there is a lack of
independent information and advice available to prescribers and recommends
that the Department of Health investigates ways of making drug and therapeutics
committees of a uniformly high standard so that they can carry out this
educational role. Although there is no acknowledgement in the report
of the role that pharmacists currently play in providing independent
guidance for prescribers, it does recommend that “specialist pharmacists” are
included on drug and therapeutics committees. “Ideally, new drugs
should not be prescribed until they have been approved by such a committee.
New drugs that might represent significant advances should be fast-tracked
through these committees,” says the report. It adds that formularies
established by these committees should be shared with local primary care
trusts so that they can be adopted by the whole local health care community.
The report also addresses the issue of prescribers being influenced by
the hospitality they receive from drug companies, for example attendance
at conferences and industry-sponsored continuing education events and
payment of “key opinion leaders” to speak and write about
products on behalf of drug companies.
The committee recommends that professional bodies, including the Royal
Pharmaceutical Society, maintain registers of interests for their members.
These registers should list substantial gifts, hospitality and honoraria
received and should be available for public inspection. It says that
professional bodies should issue advice to their members about the levels
of payments and hospitality that are considered to be acceptable.
The recommendations made in the Health Select Committee’s report
will be considered by the next government following the general election
next week (see Panel). The government will be expected to respond to
the report within two months.
Recommendations of the committee on the MHRA
The MHRA is heavily criticised in the Health
Select Committee’s
report. The committee recommends that:
· An independent, wide-reaching and in-depth
review of the MHRA is carried out to determine whether the processes
it uses for decision
making are adequate and reflect patients’ health needs and
society’s expectations
· The MHRA publishes the material it receives from drug companies
and the assessments it sends to advisory bodies
· The MHRA puts in place systems to audit randomly raw data submitted
with licence applications and that the audit results are published
· The MHRA investigates more effective post-marketing surveillance
systems and considers setting up such systems independently of
the licensing authority
· The failings of the yellow card reporting scheme are addressed,
including implementing country-wide patient reporting and improving
rates of reporting by health care professionals
· The MHRA is given the same authority to propose restrictions
on drug use as it has when approving drugs |
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The
Pharmaceutical Journal