What's the ideal relationship between the drug industry, health professionals and patients?

Feb 3 2009

The relationship between the drug industry, academia, healthcare professionals, and patients is widely believed to be at an all time low.

Five contrasting views, published on bmj.com today, discuss what the ideal relationship should be and what steps need to be taken to achieve it.

Marcia Angell, Senior Lecturer in Social Medicine at Harvard Medical School believes there should be no relationship between the drug industry and either prescribers or patients.

The purpose of the drug companies' contact with prescribers is nearly always to increase sales, and it usually involves payments of one form or another, she writes. These are often disguised as education, but the real intent is to influence prescribing habits. Likewise, direct to consumer advertising seeks to convince people that they have a chronic treatable medical condition. "We need to stop accepting the fiction that marketing, whether to precribers or patients, is good education", she concludes.

But others believe that there is a legitimate place for responsible collaboration.

Professors, Harlan Krumholz and Joseph Ross propose six standards of conduct to restore public trust. These include dispensing with direct to consumer advertising, foregoing gifts, and stopping industry sponsorship of continuing medical education. "Leading companies and physicians have already taken many of these steps to promote the best care for patients – it's time for the rest to follow," they write.

Richard Tiner, Medical Director at the Association of the British Pharmaceutical Industry says that the UK industry is committed to a stable and pragmatic partnership with the government and the NHS on medicines – one that enshrines value for money, reward for innovation, and ensures greater availability of new medicines to patients.

While Gordon Coutts, Vice President and General Manager at Schering Plough UK believes that joint working has the potential to create breakthroughs in how the UK tackles major health challenges including cardiovascular disease and teenage pregnancies.

Finally, Scott Gottlieb, a health policy analyst based in Washington DC, suggests that the industry should build trust based on good science rather than marketing related activities. Drug makers need to establish transparent guidelines for interactions with doctors and patients … and focus more squarely on matters of advancing science, monitoring for safety, and improving health education, he writes.

http://www.bma.org.uk/