An interesting letter in the BMJ highlights the incredible level of penetration that the pharmaceutical industry has in the mainstream media. This time they’re encouraging doctors to speak disparagingly about the safety of generic medicines.
The doctor interviewed in the original article is described as a prominent cardiologist, but the reporter fails to mention the numerous financial conflicts of interest that he has, including receiving financial donations from GlaxoSmithKline, the manufacturer of two drugs mentioned in the article. Bad reporting? I’ll leave it to the reader to judge.
The idea that the Western world is somehow more ‘advanced’ when it comes to issues of medical ethics and professionalism has been completely destroyed by the news that the Indian Medical Council will be introducing sweeping reforms of the rules governing industry relations. So how binding are these new regulations? A swift glance at the abstract, conveniently discussed here by Howard Brody on his brilliant ‘Hooked’ blog, shows just how major these changes are:
- No more gifts. Full stop. No specification on the price of gifts, meaning even gifts as small as pens and post-it notes are covered. To those who think this might be overkill, I suggest you read about the fascinating topic of Cognitive Dissonance. (I know, it’s a Wikipedia article, but it’s a really good introduction to the topic.)
- No more grants. Full stop. It doesn’t matter what they’re being paid for, Indian doctors will no longer be allowed to receive money from the pharmaceutical industry. Funding for medical research must be approved by the necessary institutions, and information on these transactions will be in the public domain.
- No drug endorsements. This has been in effect since 2002.
- Violation of any of these rules will be treated as ‘Misconduct’, which means they can be punishable with penalties and possible suspension.
All in all, this is a huge step in ensuring public trust in the medical profession in India is retained.
Thanks, India, for showing the rest of the world that it is possible to stand up to the self-serving logic that has perpetuated these unethical practices for so long. It’s time the Western World stood up and noticed.
The lawyers and settlements blog has a great article that gives a good little synopsis of the arguments against direct-to-consumer advertising in the US, or as we call it in Europe, information to patients. It strikes me as an odd source for a feature on this blog, but I won’t let that get in the way of my enjoying a well written, rational article.While I highly recommend you go there and read it, here are a few of the main points made in the article:
- Industry spending on marketing went up from $11 billion in 1996 to $30 billion in 2005
- Between 1999 and 2000, sales of advertised drugs increased by 24% (!!!), compared with just 4.3% for non-advertised drugs.
- Most interestingly, several states are proposing legislation that will curb direct to consumer advertising, or, at least, force pharmaceutical companies to be more open about their marketing practices. Good progress, I say.
It’s really easy to downplay the effects that marketing practices have. After all, how could a simple advert have such a profound effect on consumer practice? But the evidence speaks for itself, and companies wouldn’t be spending so much money on marketing if it didn’t work.The upside of that is, if marketing is the reason that some drugs do well, where does that leave evidence-based medicine?