Intended for healthcare professionals

Rapid response to:

Feature Drug marketing

Key opinion leaders: independent experts or drug representatives in disguise?

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39575.675787.651 (Published 19 June 2008) Cite this as: BMJ 2008;336:1402

Rapid Response:

The shadow line

In the psychopharmacologic field there are a lot of pretended new drugs strongly plugged by Drug Companies and Key Opinion Leaders (KOLs). Escitalopram (patented) is effectively better than citalopram (unpatented)? Paliperidon (patented) is really more efficacious and well tolerated than risperidon (unpatented)? Are they better with advantage of patients and National Health Service(NHS) or in the only shareholders' interest?

The plain truth is that this and other "new" drugs have similar clinical performance within a pharmacological class; they are only "me- too" drugs; but they improve the drug companies' performance. How many KLOs exalt pseudo-new drugs without to criticize the me-too drugs?

Sad to say, the once clear boundary between academic medicine and industry has increasingly become blurred. There are associated ethical and economic problems including: 1)higher pharmaceutical costs; 2)non rational prescribing; 3)waste of NHS funds to exploit otherwise for valid relief patterns; 4)limited development of alternative, independent sources of continuing education, of information, of evidence based clinical control.

While it's unwise to advocate a total separation of the academic and clinical community from the industry, more careful transparency is asked for this complicated relationship. It's necessary to remodel intelligible bounds between commercial-industrial and therapeutic-professional aspects of Medicine, to safeguard the Profession and the Patients.

Competing interests: None declared

Competing interests: No competing interests

06 July 2008
Vincenzo Fricchione Parise
senior psychiatrist
Mental Health Centre