When drug news is no newsBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7546.919 (Published 13 April 2006) Cite this as: BMJ 2006;332:919
All rapid responses
I was interested to read the recent review ‘when drug news is no
news’ (April 15th) that highlighted the helping hand that some US news
organisations are giving to pharmaceutical companies in circumventing the
FDA’s requirements for fair balance within ‘video news releases’. Recent
events lead me to suggest that the complicity of the media in
irresponsibly communicating marketing messages with the tacit support of
the pharmaceutical industry may not be confined to one side of the
Atlantic. Yet pharmaceutical companies do employ medical advisors whose
responsibilities include providing medical input to marketing strategies,
medical information to doctors and providing editorial input and guidance
to information that is disseminated.
In this respect the recent publication of an ethical framework of
guiding principles for pharmaceutical physicians1 deserves an initially
cautious welcome, as full approval should be reserved pending satisfactory
evidence of its successful application.
The framework describes an ethical duty on pharmaceutical physicians ‘to
ensure that expectations are not inappropriately raised as a result of
media briefings’ and recommends that pharmaceutical physicians should ‘be
involved in the drafting of any briefings about potential therapeutic
interventions provided to financial analysts or to the media’. If this
obligation is enacted we might anticipate that the disproportionate
publicity that arose from studies such as ASCOT2 and ASTEROID3 and was
targeted directly at the consumer via the news media will not occur when
other trials are reported in the future.
The particularly dubious habit of reporting trials that only achieve
significance with respect to their secondary endpoints4 (i.e. ASCOT2,
PROACTIVE5) with the same vigour and publicity as if the primary endpoint
had been achieved should now also become relegated to history. One
suspects that this will prove to be a rather optimistic expectation as it
is difficult to define which particular actions constitute raising
expectations inappropriately. Details regarding how deviations from this
guidance will be managed are necessary if the proposals are to be
effective and taken seriously.
Also thrown into sharp relief is the paucity of guidance and
regulation relating to those health service physicians whose association
and financial dependency on the pharmaceutical industry can seemingly
approach that of pharmaceutical physicians. It would seem that of the
agencies available the General Medical Council might be best suited to
considering these issues however until this need is identified
pharmaceutical physicians may, ostensibly, be held more accountable than
their non-pharmaceutical colleagues. Perhaps it is now time to abandon the
artificial dichotomy between pharmaceutical physicians and non-
pharmaceutical physicians and recognise that similar strictures should
apply to all.
Dr Rubin Minhas
1. Guiding Principles for Pharmaceutical Physicians from the Ethical
Issues Committee of the Faculty of Pharmaceutical Medicine of the Royal
Colleges of Physicians of the UK. Int J Clin Pract. 2006 Feb;60(2):238-41
2. Dahlöf B, Sever PS, Poulter NR, et alfor the ASCOT investigators.
Prevention of cardiovascular events with an antihypertensive regimen of
amlodipine adding perindopril as required versus atenolol adding
bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac
Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre
randomised controlled trial. Lancet 2005; 366: 895-906
3. Nissen SE, Nicholls SJ, Sipahi I, et al. Effect of very high-
intensity statin therapy on regression of coronary atherosclerosis: the
ASTEROID trial. JAMA. 2006;295:1556-1565.
4. How well does the evidence on pioglitazone back up researchers'
claims for a reduction in macrovascular events? Freemantle N. BMJ
2005;331:836-838 (8 October)
Over the last 10 years I have attended educaitonal meetings, received travel grants, honoraria for lectures and advisory boards from a number of pharmaceutical companies including AstraZeneca, Bayer, Fournier, GlaxoSmithKline, Pfizer, Merck, MSD and Sanofi-Aventis.
Competing interests: No competing interests