11/05/2008 by Merav.

A group of members of European parliament with a speacial interest in breast cancer has cut its ties with a breast cancer advocacy group, Europa Donna, because of the group’s acceptance of financial support from drug companies. “We at EPGBC (European parliamentary group on breast cancer) reject further co-operation with Europa Donna because the board of the European lobby group became more and more a lobby instrument for the market interests of the big pharmaceutical companies”.

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11/05/2008 by Merav.

Drug and medical device companies should be banned from offering free food, gifts, travel and ghost-writing services to doctors, staff members and students in all 129 of the nation’s medical colleges, an influential college association has concluded.

The proposed ban is the result of a two-year effort by the group, the Association of American Medical Colleges, to create a model policy governing interactions between the schools and industry. While schools can ignore the association’s advice, most follow its recommendations.

Rob Restuccia, executive director of the Prescription Project, a nonprofit group dedicated to eliminating conflicts of interest in medicine, said the report would transform medical education.

“Most medical schools do not have strong conflict-of-interest policies, and this report will change that,” Mr. Restuccia said.

The rules would apply only to medical schools, but they could have enormous influence across medicine, said Dr. David Rothman, president of the Institute on Medicine as a Profession at Columbia University.

“We’re hoping the example set by academic medical colleges will be contagious,” Dr. Rothman said.

Drug companies spend billions wooing doctors — more than they spend on research or consumer advertising. Medical schools, packed with prominent professors and impressionable trainees, are particularly attractive marketing targets.

So companies have for decades provided faculty and students free food and gifts, offered lucrative consulting arrangements to top-notch teachers and even ghost-wrote research papers for busy professors.

“Such forms of industry involvement tend to establish reciprocal relationships that can inject bias, distort decision-making and create the perception among colleagues, students, trainees and the public that practitioners are being ‘bought’ or ‘bribed’ by industry,” the report said.

A group of influential doctors decried these practices in a 2006 article in The Journal of the American Medical Association, and said that medical schools should ban them. In the article’s wake, the medical college association created a task force.

With Dr. Roy Vagelos, a former Merck chief executive, serving as the task force’s chairman and the chief executives of Pfizer, Eli Lilly, Amgen and Medtronic on the roster, some who advocate for greater restrictions on industry influence in medicine predicted that the report would be weak.

They were wrong.

In addition to the gift, food and travel bans, the report recommended that medical schools should “strongly discourage participation by their faculty in industry-sponsored speakers’ bureaus,” in which doctors are paid to promote drug and device benefits.

It recommended that schools set up centralized systems for accepting free drug samples or “alternative ways to manage pharmaceutical sample distribution that do not carry the risks to professionalism with which current practices are associated.” It suggested that schools audit independently accredited medical education seminars given by faculty “for the presence of inappropriate influence.” And it said the rules should apply to faculty even when off-duty or away from school.

Speakers’ bureaus and drug samples are pillars of the industry’s marketing operations, and many medical school professors have resisted efforts to restrict them. Only a handful of medical schools presently bar faculty members from serving on speakers’ bureaus, so if this recommendation is widely adopted, it could transform the relationship between medical school faculty and industry, and it could change substantially the way medical education is routinely delivered.

Indeed, the chief executives of Pfizer and Eli Lilly dissented from the report’s recommendation regarding speakers’ bureaus.

“We continue to believe that these types of programs, which are subject to clear regulations regarding their content, can be worthwhile educational activities,” wrote Jeffrey B. Kindler of Pfizer and Sidney Taurel of Lilly.

David Beier, an Amgen senior vice president, wrote a letter that endorsed the report’s recommendations but disagreed with some of its text “because we have a different view about the accuracy concerning representations about the motives of the participants in industry-academic interactions.”

Ken Johnson of the Pharmaceutical Research and Manufacturers of America, said his group would review the report.

“Providing physicians — and medical students — with timely, accurate information about the medicines they prescribe clearly benefits patients and advances healthcare throughout the United States,” Mr. Johnson said.

Dr. Robert J. Alpern, dean of the Yale School of Medicine, said that the university presently had no limits on participation in company speakers’ bureaus, but that because of the medical college association’s report he was thinking of taking them on.

“I don’t have a problem with doctors making $3,000 or $5,000 a year on the side,” he said, “but it’s a totally different thing when it’s $80,000.” Even more distasteful, Dr. Alpern said, is that the slides used in many of these presentations are created by drug makers, not the speakers.

“That’s like ghost-talking,” Dr. Alpern said.

Dr. Arthur S. Levine, dean of the University of Pittsburgh School of Medicine, said that when he graduated from medical school in 1964, Eli Lilly gave him his first doctor’s bag, and Roche gave him an Omega watch for being valedictorian. He still has the watch.

But this year’s graduating class of doctors at Pittsburgh will not be allowed to accept any of these gifts, and the daily pizza lunches brought by drug companies are gone, he said.

Julie Gottlieb, assistant dean of policy coordination for Johns Hopkins University School of Medicine, said Hopkins had adopted some of the association’s recommendations and was considering others.

“This report is bound to influence our deliberations,” she said.

Dr. Vagelos, formerly of Merck, said that the report’s recommendations were certain to face resistance among faculty who liked the present system.

“The outcome of this for the industry is that those companies that are strong in science will always be welcome at medical colleges and others won’t,” Dr. Vagelos said.

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11/05/2008 by Merav.

The Association of American Medical Collegs suggests that all 129 member schools should prohibit pharmaceutical and devices manufacturers from providing gifts, food and travel to doctors, faculty members and students. The report says that medical schools and teaching hospitals increasingly depend on industry support for core educational missions. The report will be considered at the association’s meeting in June 2008.

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30/04/2008 by Merav.

Top-notch policy experts from around the world gathered to make formal policy recommendations about patents to Third World governments struggling with disease. Many will claim that patents allow Western drug companies to keep drug prices artificially high, and that patent-breaking is a cheap and easy way to get poor patients the drugs they need. They’re wrong on both counts.

For starters, the drugs needed in the developing world aren’t patent protected. A 2004 study published in the journal Health Affairs showed that less than 2 percent of the 319 prescription drugs on the WHO’s Model List of Essential Medicines are actually under patent.

What patients in the Third World need aren’t patent-busting bureaucrats but more roads, doctors, hospitals, nutritious food, and good sanitation. When roads are in disrepair, it can be particularly difficult to reach rural populations, where disease burden is highest. In places with no electricity, temperature-sensitive pills often go bad before anyone can benefit from them. Refrigerated Coca-Cola vans have been shipping polio vaccines to the hinterlands of Cameroon, because most roads are unmotorable. Even if roads were available and medicines were donated, they must be prescribed by qualified medical staff.

Patients will also need good drinking water and a good meal to enhance recovery from disease. However, the doctor-patient ratio is abysmally low and close to 60 percent of Africans do not have access to good sanitation and many subsist on less than a dollar a day.

Patents are actually a critical part of the solution. They protect the financial incentives that drive pharmaceutical companies to create innovative medications in the first place. It takes an average of US$800 million and 10-15 years to bring a new drug to the market. Patents ensure that pharmaceutical companies can recoup that enormous investment.

If countries start breaking patents, though, firms lose out on sales. And they’re less able to finance the development of new cures. That’s a blow to the public health efforts of all countries, rich and poor. Ghana’s health Minister told me that he fails to see how people could hold antagonistic positions against pharmaceutical companies, because in his
own words “if drugs are being made, then people must be sick somewhere – it is not for charity”.

Poor patent enforcement also gives rise to potentially harmful copycats. The generic pharmaceuticals manufactured in the developing world often don’t comply with international safety regulations. Low-quality and counterfeit drugs are common. The WHO estimates that 10 per cent of the world’s drugs are counterfeit. Patent-theft is making the problem worse.

It’s also important to realise that drug companies are not as blindly self-serving as many anti-patent groups portray them to be. Global pharmaceutical companies have worked for years with groups like the WHO and the UN Children’s Fund to lead the fight against HIV/AIDS, malaria, tuberculosis, and other diseases plaguing the developing world.

Just a few months ago, Pfizer, GlaxoSmithKline, and Merck donated $450 million in medicines to Burkina Faso, one of the poorest countries in the world. These sorts of philanthropic efforts are less likely if drug companies start struggling just to break even.

Many important steps need to be to taken to improve medical care in the Third World. Despite what the health activists are saying, stealing drug patents and stifling the creation of life-saving medicines is not one of them. It seems that a sensible route to take would be dialogue with pharmaceutical companies for differential pricing for developing world markets while making every effort to improve the well being of citizens.

Open, decentralised and transparent government, lower trade tariffs, free speech, the rule of law, relaxed business entry and exit rules, property rights, and freedom to contract and freedom from contract would be important to help poor citizens buy their own health insurance against diseases.

Author: Franklin Cudjoe is executive director of IMANI Center for Policy and Education, a think-tank located in Accra, Ghana. He spoke at the IGWG
conference in Geneva on 28-29 April, 2008. This article was first published on AFRIK.COM on Wednesday 30 April 2008 at http://en.afrik.com/article13423.html

Thanks to Reinhard Huss for sending this interesting article in.

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30/04/2008 by admin.

Update us on any news going on in the international pharm world!

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30/04/2008 by admin.

Update us on any UK pharma news!

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30/04/2008 by admin.

Update us on any new information about medications. Let’s get educated!

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29/04/2008 by admin.

Dear all,
Welcome to our new blog system. Sign up as a new user and soon after, you will have access to start blogging too.
Enjoy,
Merav

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29/04/2008 by admin.

Lots of debate at Leeds with Peter Mansfield (right) and Rory O’Connor (left)-photo by Lorraine Sue-Fern Yeung
What made 120 students stay late at University on a Friday evening last week? Well, Medsin-Leeds and PharmAware Leeds came together to put on a huge event, tackling a massive issue that managed to create a real buzz around the issue. The issue is that of pharmaceutical companies and their influence on doctor’s prescribing habits. To stimulate discussion and further exploration of this issue, the following motion was debated:

“The house believes the relationship between the medical profession and the pharmaceutical industry is detrimental to patient health”.

The event was introduced by Omar Jundi, PharmAware-Leeds co-coordinator. He explained that this is a large issue discussed by the profession and brought up often in medical journals etc. Four speakers, two for each side of the debate, had their say - and a lengthy, passionate question and answer session then ensued! These speakers included the inspirational Peter Mansfield, physician from Australia and head of Healthy Skepticism, Dr Rory O’Connor, Senior Lecturer in Rehabilitation Medicine, Mr Dermot Burke, colorectal surgeon, and Dr Jan Clarke, sexual health physician. We have summarised each of their talks at the end of this blog entry.

The event was a culmination of discussions on medical professionalism, and the wider duties of doctors, between Medsin Leeds, PharmAware Leeds, and Professor Trudie Roberts who is the Head of the School of Medicine. It was decided that it would be prudent for the School of Medicine at Leeds to declare it’s stance on the issue, and use the event to enrich the policy, considering the importance of the issue on the education of thousands of medical students in the UK.

At the ballot box, it was evident that the majority of students supported the motion. This means that the University of Leeds, School of Medicine has taken the first steps to forming policy on the interactions of the pharmaceutical industry and medical students. This could open up the way to becoming the UK’s first ‘PharmaFree’ medical school following the successful examples of Stanford and Penn State Universities in the USA.

All in all, it was a fantastic evening. It’s amazing to see so many students getting passionate about issues, such as these, that matter so much in our ability to care for our patients. It was fantastic to have students working alongside the Head of the School of Medicine, and we hope that this format can be exported to other medical schools. We’d be happy to help, just get in touch!

Although the subject remains complex as ever, we believe that getting students sensitized to the issues before they are exposed to day-to-day ethical dilemmas is more than a good thing - it’s our duty. Sunil Bhopal: ssbhopal@googlemail.com and James Chan: james.chan.uk@gmail.com

Peter Mansfield - Healthy Skepticism
The first speaker was Peter Mansfield. He began by telling us that when considering this difficult issue we should never think about ourselves. He pointed out the difficulties of questioning one’s own integrity and pointed to a funny statistic - when asked if interactions with industry affect their practises, 70% of doctors say ‘No’. But when asked the same question, but this time about their colleagues - the numbers are reversed… 70% say yes!

He discussed a lot about ‘human nature’, and the unintended biases that can creep into our practise no matter how intelligent we are. Peter pointed out as we appraise evidence presented to us, we become more confident, but unfortunately - this leads to doctors missing the more subtle signs of negative interactions with industry.

To finish with, Peter talked about his lifelong search for a piece of good drug promotion. He says that he has come across several he thought would make the grade - but there’s always a catch. If anyone finds a piece please send it over to him via the website, and for examples of the bad stuff - have a look there too, there’s reams of it!

Dr Jan Clarke
The second speaker of the evening talked about her relationship with industry, and as an HIV physician how she believes it to be of benefit to her patients. Dr Clarke described her interactions as ‘fierce’, and talked about how she is able to get data from industry that has not been published, and that she needs to be in touch in order to access postgraduate training, and research meetings. She did, however, acknowledge the pitfalls of interaction, describing promotional meetings as ‘biased’.

Dr Clarke then went on to discuss what industry does for her - this includes developing drugs, supporting testing of these drugs and providing information in the ever-changing field of modern medicine. She held up her BNF (British National Formulary) and pointed out the impracticalities of learning it off by heart!

Dr Clarke said that the post-it notes and pens provided to British doctors “saves the NHS its stationary budget” and pointed to the work that the companies do in resource-poor settings.

Finally she finished by saying that doctors should be *critical* and *sceptical*, but that given these caveats, “[industry] help us keep our patients informed”

Dr Rory O’Connor
Rory began with a trademark phrase…“It started with a sandwich” he said. He talked us through his life of interaction with industry - from sandwiches and pens to dinners and hotels. Holding up an invitation letter, he showed how he was invited to Monaco to speak on the weekend where there ‘happened’ to be a Grand Prix in town…

Rory pointed us to research showing figures for drug companies that directly refute their arguments over high drug pricing. He said that only 30% of budgets are spent on Research and Development, with the other 70& going on marketing, profit etc. The top 10 companies in the Fortune 500, he pointed out, are pharmaceutical companies.

Holding up a drug promotional pen, Rory asked the audience - “Are you that cheap?!” to which there was much chuckling, and at least a few nodding heads!

Feeling that the companies “insult our intelligence” Rory suggests that we look at unbiased sources of information in order to maintain our respect as a profession. He points out that we are well paid, and don’t need free sandwiches and pens!

To end with, Rory made an interesting point… “If the drugs are that good, they should sell themselves…”

Mr Dermot Burke
Dermot added some new points, as well as some light relief to what was turning into quite a heavy evening by this point!

He described his experiences of a drug night out - “boring doctors, dry food and no football” seemed to be his take on this! Describing, somewhat tongue-in-cheek, reps as being the “spawn of Satan” he claimed that all doctors know this, and posed a question to the audience - “where is the harm?”.

Mr Burke feels that the education provided by reps is a great way for doctors to learn about other specialities, and that networking is an important part of medicine - and the free lunches simply “oil the wheels” of this interaction.

In a world of compromise, Mr Burke suggested, we should not be looking at no interaction between industry representatives and doctors, but that we should be using industry to our advantage - as he put it… we need to “Keep our friends close, but our enemies closer”…

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