About Healthy Skepticism

Information about Healthy Skepticism Inc

What is Healthy Skepticism?

The Medical Lobby for Appropriate Marketing (MaLAM) was established in 1983 and in 2001 changed to a new name: Healthy Skepticism.

Healthy Skepticism is an international non-profit organisation for health professionals and everyone with an interest in improving health. Our main aim is to improve health by reducing harm from misleading drug promotion.

Initially MaLAM concentrated on misleading promotion in developing countries where the consequences may be worse because of a lack of regulatory controls and lack of independent information. Healthy Skepticism has continued this work and expanded it to include inappropriate promotion from any country.

Reports of Healthy Skepticism / MaLAM's activities and impact have been published in the Lancet, the British Medical Journal and elsewhere.
(See Publications about Healthy Skepticism/MaLAM
and Publications written by Healthy Skepticism/MaLAM)

Healthy Skepticism's Aims

1. Improving health by reducing harm from inappropriate, misleading or unethical marketing of health products or services, especially misleading pharmaceutical promotion.

2. Investigating and communicating about marketing practices.

3. Promoting healthy skepticism about marketing practices via advocacy, research and education.

4. Developing, supporting and evaluating initiatives to reduce harmful marketing practices, including reform of regulations and incentives.

5. Developing, implementing and evaluating educational strategies to improve health care decision making, including evaluation of drug promotion.

6. Supporting compassionate, appropriate, sustainable, evidence-based health care, provided according to need, for optimal health outcomes.

7. Providing practical opportunities to advance the aims of Healthy Skepticism Inc.

Healthy Skepticism Management Group 2007

Executive

Chair
Dr Jon Jureidini (Child psychiatry) Adelaide, Australia
jon@healthyskepticism.org

Deputy Chair
Dr Agnés Vitry (Pharmacy) Adelaide, Australia

Treasurer
Dr Heather Carter (General practice) Adelaide, Australia

Secretary
Dr Peter Mansfield (General practice) Willunga, Australia
peter@healthyskepticism.org

Management Group Members

Dr Dee Mangin (General Practice) Christchurch, New Zealand
Ms Joana Ramos (Social Work and Health Policy) Seattle, USA
Prof Joel Lexchin (Emergency Medicine and Health Policy) Toronto, Canada
Mr Jörg Schaaber (Sociology and Journalism) Bielefeld, Germany
Ms Melissa Raven (Public Health) Adelaide, Australia

Staff
Administrative Assistants (part time)
Robyn Clothier robyn@healthyskepticism.org
Clare Mansfield

Director
Dr Peter Mansfield (General practice, Willunga, Australia)
peter@healthyskepticism.org

Are we effective?

Healthy Skepticism operated under the name MaLAM from 1983 to 2001. MaLAM's main strategy was writing letters to drug companies. These letters led to withdrawal or reformulation of some drugs and withdrawal of modification of many advertisements.

Subscribers have reported increased scepticism of pharmaceutical promotion, increased pharmacological knowledge and increased critical appraisal skills.

Products where withdrawal or reformulation have been promised following letters from MaLAM:

Company Product	Promoted Indication
Bayer arsenic/strychnine/glucose/alcohol etc	Tonic
Ciba Geigy (now Novartis) nikethamide	Neonatal respiratory stimulant
Parke Davis / Warner Lambert chloramphenicol/streptomycin	Antidiarrhoeal
Pfizer gonadal hormones/vitamins etc	Tonic
Nicholas / Sara Lee (now Roche) aspirin (paediatric formulation)	Analgesic
Smith Kline & French (now SmithKline Beecham) furazolidone/kaolin/pectin furazolidone/metronidazole/kaolin/pectin	Antidiarrhoeals
Sterling / Winthrop phenobarbitone/ephedrine/theophylline	Anti-asthma
Upjohn neomycin/kaolin/pectin	Antidiarrhoeal
Wellcome ammonium chloride/guaiphenesin/ trimethoprim/sulphamethoxazole	Anti-respiratory tract infection therapy
Wyeth / American Home Products uridine triphosphate	Therapy for developmental delay

In time we will be able to report on the effectiveness of our new ways of working.

Growing worldwide support

Healthy Skepticism's achievements would never have occurred without the active support of our subscribers all around the world. They are the driving force behind the organisation's success.

Healthy Skepticism's core funding source is subscriptions so as to ensure that it remains controlled by individual health professionals and members of the public with an interest in improving health.

However: "We are now ready, willing, and able to collaborate with any governments, companies, universities, or organisations for health professionals or consumers who are interested in improving health while saving money." - Mansfield PR, Lexchin J, Vitry A, Doecke CJ and Svensson, S. Drug advertising in medical journals. Lancet 2003 Mar 8; 361(9360)879.

Consequently we have provided paid services for organisations interested in improving health care including the following:

Australian Government's Pharmaceutical Education Program

Australian Health Insurance Commission

Australian Medicines Handbook

Australian National Prescribing Service

Health Action International

PHARMAC New Zealand

Flinders University Medical School

University of Adelaide Medical School

University of Queensland Pharmacy School

University of South Australia Pharmacy School

University of Tasmania Medical School

World Health Organisation's Drug Action Program

What others say about us

"to influence multinational corporations effectively, the efforts of governments will have to be complemented by others, notably the many voluntary organisations that have shown they can effectively represent society's public-health interests...
A small group known as Healthy Skepticism (http://www.healthyskepticism.org; formerly the Medical Lobby for Appropriate Marketing) has consistently and insistently drawn the attention of producers to promotional malpractice, calling for (and often securing) correction. These organisations [Healthy Skepticism, Médecins Sans Frontières and Health Action International] are small, but they are capable; they bear malice towards no one, and they are inscrutably honest. If industry is indeed persuaded to face up to its social responsibilities in the coming years it may well be because of these associations and others like them [NoFreeLunch, Social Audit]."
- Dukes MN. Accountability of the pharmaceutical industry. Lancet. 2002 Nov 23; 360(9346)1682-4. [Full text free after registration on the Lancet website]

"I have regarded highly what has been done by MaLAM/Healthy Skepticism over the years. I have learnt about the pharmaceutical industry, have been educated about appropriate use of medications which has led to changes in my prescribing habits, and remain supportive of endeavours to encourage Drs to prescribe wisely.
While remaining supportive of EBM I have concerns about some of the ruthless sequelae of applying EBM, and hence appreciate the word "compassion" in one of your statements.
Keep up the good work.
I'd be pleased to pay $75 a year."
- Dr Ian Traise, B Med (Newcastle) FRACGP

"The recent case studies [ July/August 2001 Vol 19 No 7/8 Hormone Replacement Therapy HTML. - Acrobat pdf version and January/June 2001 Vol 19 No 1/6 Scepticism and beliefs about new drugs. ] were very helpful and a good format."
- HealthySkepticism subscriber

"I attended your series of lectures regarding Drug Promotion, initially thinking that it would be a leisurely break from the "real" pharmacology of drug doses, classes, and so forth. So after those lectures, I was shocked. Positively, however. I was suddenly made aware that the subtle yet powerful effects of drug promotion were just as important and "real" as receptor-blocking and secondary messenger systems. Through a combination of statistics, clinical evidence, anecdotes and humour, you made your points succinctly and clearly."
- Third Year medical student.

Responses to a contribution from Healthy Skepticism to a debate on the nofreelunch e-mail list:

"This is a beautifully written and compelling comment. well done!" - JRH

"You're phenomenal!" - ACB

"Brilliant rebuttal." - DF

"Masterly!" - JJ

The following comments were made when Healthy Skepticism was operating under its previous name MaLAM (Medical Lobby for Appropriate Marketing).

MaLAM "has made a substantial impact on grossly inappropriate marketing in the developing world."
- Smith AJ. Leading article. Med J Aust 1992; 156: 299

"I am impressed by MaLAM. I think the newsletters are fascinating demonstrations of the application of evidence-based medicine principles."
- The late Prof. Chris Silagy, then Director of the Australasian Cochrane Centre, Personal correspondence