That pharmaceutical companies may be given permission to provide information about their prescription medicines in Europe^{[1] 1} is troubling.

Thankfully, the ban on direct to consumer advertising stands. This sort of engagement with consumers has not always benefited patients: in the case of Vioxx strong patient interest generated in the drug by its producer Merck translated into “blockbuster” status. Merck’s later withdrawal of the drug came after perhaps thousands of preventable adverse events.^{[2] 2}

Monitoring is obligatory and will be carried out by member states before dissemination. However, the industry has found its way around monitoring systems before: the Food and Drug Administration’s vetting of US pharmaceutical advertisements has often been ineffective, resulting in dissemination of false and misleading advertising material.^{[3] 3 [4] 4}

Patients require unbiased and objective information, and have the right to the highest quality information. However, the description of information in the European proposals is inadequate and may come with some of the negative side effects of direct to consumer advertising. The profile of profitable branded drugs may be increased, which will increase spending on prescription medicines by patients and the NHS. Unbiased and objective information would be best provided by healthcare professionals, who are trained to appraise and interpret the evidence on clinical and cost effectiveness.

Healthcare professionals are increasingly aware of the potential conflicts of interest in having close ties with the pharmaceutical industry and its subsequent impact on patient safety and care.^{[5] 5} It would be very unfortunate if the influence of the pharmaceutical industry’s marketing apparatus instead refocused on patients, perpetuating the industry’s influence yet longer.

We call on the European Commission to abandon its proposals and explore options for providing a more impartial and unprejudiced system of high quality peer reviewed information.

Cite this as: BMJ 2009;338:b290

Jonathan A Currie, 4th year medical student¹, Helen Preston, intercalating medical student², Sudath Weerapperuma, 4th year medical student¹

¹ University of Bristol Medical School, Bristol BS2 8DZ, ² Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ

[6] jonny.currie@gmail.com

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Competing interests: None declared. HP is president and JAC campaigns director of Medsin, a student global health network. SW is a representative of Pharmaware, a UK campaign aiming to maximise ethical interactions between healthcare professionals and pharmaceutical companies.

References

1. Watson R. Proposal to allow drug companies to give information to public sparks outcry. BMJ 2008;337:a3043. (16 December.)[7] [Free Full Text]
2. Topol EJ. Failing the public health—Rofecoxib, Merck and the FDA. N Engl J Med 2004;351:1707-9.[8] [Free Full Text]
3. Government Accountability Office. Prescription drugs: improvements needed in FDA’s oversight of direct-to-consumer advertising. Washington, DC: GAO, 2006.
4. Angell M. The truth about drug companies. New York: Random House, 2004.
5. Sweet M. Australian health professionals warned against featuring in advertisements. BMJ 2008;337:a2951. (11 December.)[9] [Free Full Text]