Department of Health ends contract with drugs bulletin

London

Madeleine Brettingham

The Drug and Therapeutics Bulletin, a journal that has been distributed free by the NHS and provided doctors across England with advice about medical treatments for over 40 years, has had its funding stopped by the Department of Health in the latest round of cost cutting in the NHS.

The last minute decision, which came only two hours before the bulletin’s previous contract ended in March, leaves the publication’s future uncertain and threatens to increase yet further the influence of the drug industry in doctors’ prescribing, said its editor, Ike Iheanacho.

"In April last year the [parliamentary] health select committee pointed to us as an invaluable source of independent advice. So it seems strange that they have done this. The fear is that now doctors will be reliant on pharmaceutical promotion," Dr Iheanacho said.

"We have an unrivalled reputation for looking critically at the information on offer and giving doctors practical guidance, and many have told me they would find it harder to make decisions without us. The danger is it will be difficult to evaluate expensive new treatments that haven’t stood the test of time," he said.

The journal, which is available online and is sent to all NHS doctors in England, is published by the UK Consumers’ Organisation (now known as Which?). In a survey carried out in winter 2005 89% of readers said the publication influenced their decisions and recommendations about treatment. Dr Iheanacho said that at least 100 have complained to the secretary of state for health about its withdrawal.

But a health department spokeswoman said that the cuts represented inevitable belt tightening. "The contract was due to end in March 2006, and as we were not sure whether sufficient funding would be available to start a new contract we gave the Consumers’ Association warning of this," she said. "The contract has not been renewed, and officials are discussing the implications of this decision."

NHS trusts’ balance sheets indicate that the NHS has racked up a deficit of hundreds of millions of pounds over the past financial year.

The bulletin has gained a reputation for campaigning against the drug industry’s more misleading pronouncements. In 2002 it secured the withdrawal of UK advertising for the oral contraceptive ethinylestradiol with drospirenone (Yasmin), whose makers Schering Health described it as "a pill for wellbeing" and as having a positive effect on weight and skin condition. It also challenged advertising for Viteyes, a supplement for macular degeneration, in March this year.

The latest issue of the bulletin questions the cost effectiveness of two new cancer drugs, bevacizumab and cetuximab. The editorial team estimates that if its advice on the drugs leads doctors to make at least one fewer inappropriate prescription in each primary care trust the NHS could save more than £9m (€13.1m; $16.7m) a year.

The team is writing to the bulletin’s 119 000 readers asking them to lobby the secretary of state over the decision. The last issue funded by the health department is published this week. The editors argue that the journal could not continue on a subscription only basis, because doctors and their trusts do not have the money.

The bulletin’s contract is worth £1.4m over six years. The NHS’s drugs budget is £8bn a year, and the drug industry spends £1.7bn a year in the United Kingdom on advertising.

The NHS provides an online information service, the National Electronic Library for Health, which aims to become an alternative source of guidance for healthcare workers.