An alternative set of principles for consideration

It is disappointing to see so many reputable organisations join the Association of the British Pharmaceutical Industry (ABPI) in endorsing such a damaging and ill conceived document.1 2 Unreferenced statements such as “Healthcare and industry professionals are able to manage their relationships with each other without compromising clinical decision making,”2 at odds with a growing body of evidence,3 are unhelpful.

We would like to suggest an alternative set of principles for consideration:

• 1) Despite its flaws, we are probably stuck with the current model of pharmaceutical research and development, at least in the short to medium term.

• 2) If industry wishes to make information on its products available, it can publish in a peer reviewed journals like the rest of us. Clinicians should treat these data with caution because funding source is strongly associated with reported outcome in published trials.4

• 3) It is difficult to assess how others’ conflicts of interest might affect their account of the evidence base. For this reason, we should demand review articles and medical education be delivered, in almost all cases, by people with no industry links. The presence of people with strong industry links on guideline committees is totally unacceptable.5

• 4) Industry codes of conduct usually have limited impact—the ABPI code is a good example of this.

• 5) Patients would be shocked if they realised the extent to which our profession depends on industry. Blanket bans on contact with industry reps, of the kind imposed in several American medical schools, are a step in the right direction.