Commercial source of drug information: comparison between the United Kingdom and IndiaBMJ 1994; 309 doi: http://dx.doi.org/10.1136/bmj.309.6960.990 (Published 15 October 1994) Cite this as: BMJ 1994;309:990
- R K Dikshit,
- N Dikshit
- Correspondence to: Dr R K Dikshit.
- Accepted 7 February 1994
The prescription of proprietary drugs and the lack of an independent formulary may contribute to the use of a commercial source of drug information by doctors. The Monthly Index of Medical Specialties (MIMS) is one such publication available in both the United Kingdom and India. We compared the two editions for differences in the information provided and the quality of advertisements.
Methods and results
We analysed the March 1992 issue of the British edition of MIMS and the August 1993 issue of the Indian edition, for several general features (see table). We recorded the numbers of advertisements, products under each heading and on each page, and words used to describe a product. Full page advertisements were studied in detail as described previously.1 Briefly, information provided, drug names, and the use of superlatives and visual images were recorded.
The general features of both editions were similar (table). The initial description of a drug group focused mainly on the indications and adverse drug reactions. The quality of the information given varied from group to group, differing inconsistently between the two editions. Product information gave the trade and generic names, manufacturer, preparation(s), dosage, and cost, with just the numbers of indications and side effects. Product appearance and its legal category were given in the British but not the Indian edition. Therapeutic comparisons between the drugs and drug groups were never given, and the information provided was generally insufficiently detailed in both editions. Legibility was poor in the Indian MIMS. Twenty three tables and charts were given in the British MIMS but none was given in the Indian version. Some peculiar headings appeared in both editions (cerebral activators, enzymes-digestives, respiratory stimulants in the Indian MIMS; wart removers, leg ulcer treatments in the British version). The table shows important differences in the number of products listed under many therapeutic headings.
Indications and side effects were omitted in 51% and 86% of advertisements respectively in the Indian edition and in 59% and 57% respectively in the British edition. Cost was never given in Indian advertisements and was missing in 21 (57%) British advertisements. Space was regularly lost in unnecessary images; superlatives were used, without further qualification, rather freely in Indian advertisements (high quality, unsurpassed, unmatched, fastest, best, super-spectrum, safe) and with slightly greater caution in British advertisements (revolutionary, outstanding, power, faster, first line, trusted). Advertisements were usually placed strategically in the appropriate therapeutic section.
Although the information given in MIMS is generally well organised, it lacks education value because of its lack of adequate elaboration and comparison. General features should be described initially at length with some points of comparison, and differences being pointed out only in individual entries. The number of entries per page could be reduced, and MIMS should be more selective in its entries - for example, why include so many tonics, cough remedies, antidiarrhoeals, and non-steroidal anti- inflammatory drugs in the Indian version? The Indian version of MIMS needs several other improvements as noted above.
Drug advertisements continue to be irrational. Larger numbers of advertisements have been analysed before with similar conclusions.1,2 In the United Kingdom the code of practice of the Association of the British Pharmaceutical Industry3 regulates drug advertising and is said to be broken commonly.4 The Indian Drug Manufactures' Association seems to have a code of practice like that of the Association of the British Pharmaceutical Industry; the Indian edition of MIMS follows the code of the International Federation of Pharmaceutical Manufacturers' Associations, and both these codes seem to have been broken in many cases in our study. There is clearly a need for tough codes and laws; equally important is their rigorous implementation, particularly in developing countries. While the drug indexing journals in India continue to increase and become more powerful, prescribers need to be reminded periodically of their own limitations and the general credibility of drug advertisements.