Healthy Skepticism Library item: 10140
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
Othman N.
Self-regulation open to abuse
The New Straits Times 2007 May 8
http://www.nst.com.my/Current_News/NST/Tuesday/Letters/20070508082931/Article/index_html
Full text:
A RECENT report (“Doctors’ in cahoots with drug companies” – NST, March 14) and the ensuing discussions (“Concerns are unfounded” – NST, March, 20; “Patients’ need come first with doctors” – NST March 22; “End these unethical practices” – NST, March 29) on the issue of pharmaceutical promotion shows that the Malaysian public has started to question doctors’ relationship with drug companies.
Globally, interactions between doctors and the pharmaceutical industry have attracted considerable debate and attention.
In the United States, a press release on Feb 12 by The Prescription Project called on academic medical centres, professional medical societies and public to end conflicts of interest resulting from the billions spent annually on pharmaceutical promotion.
Pharmaceutical promotion is persuasive communication conveying medical and product information from drug companies to doctors. It often enables busy doctors to reach correct conclusions quickly but leave them vulnerable to manipulation.
Even prescribers who think that they obtain their knowledge from the scientific literature can be influenced by promotional sources without being aware of it.
Pharmaceutical promotion is one of the main sources of information on medicines for prescribers, especially for newly marketed drugs but the information must be of high quality and unbiased because it has serious implications for public health.
Studies have shown that the quality of information in pharmaceutical promotion is often poor. Inaccurate or incomplete information provided in pharmaceutical promotion could lead to poor prescribing, with negative health consequences.
For instance, the worldwide aggressive promotion of the arthritis drug Rofecoxib failed to mention cardiac risks. This inaccurate or incomplete promotion continued for four years despite evidence from a large-scale randomised controlled study showing increased cardiac risks.
Doctors’ interactions with the pharmaceutical companies may provide benefits for therapeutics, education and research. However, this interaction might interfere with doctors’ independent professional judgment.
In Australia, a study reported that 6.7 per cent of doctors delayed research publication and 5.1 per cent of doctors failed to publish negative findings due to commercial reasons.
It is true that drug promotion is controlled and regulated. Malaysia is an example of a country where the drug industry self-regulates its promotional activities.
The effectiveness of the Pharmaceutical Association of Malaysia’s (PhAMA) code of conducts for prescription (ethical) products in controlling pharmaceutical promotion is questionable as no research has been done to examine if it is implemented in practice.
However, the conflict between the commercial objectives and the ethical and scientific goals of promotion may potentially lead to serious weaknesses in the way in which the code is enforced.
Evidence from Canada shows that industry self-regulatory code of conduct has serious weaknesses in critical areas in the enforcement of codes governing pharmaceutical promotion.
Therefore, there is an urgent need for independent monitoring and research, which may provide information on pharmaceutical promotion activities to the government. Careful critical appraisal of pharmaceutical information by doctors is crucial to ensure that information given to them is recent, accurate, balanced and supports the quality use of medicines in our country.
