HEALTHCARE PHARMACEUTICAL INDUSTRY

Healthcare Pharmaceutical Industry

Healthcare Pharmaceutical Industry

Healthcare Pharmaceutical Industry

Industry and physicians have to face up to the fact that the heritage of our relationship is one of practices and habits that, although acceptable in the past, do not sit comfortably with today's values and ethical standards. Industry and healthcare professionals have moved considerably in developing codes of conduct and practice to match today's needs and standards. Nevertheless, concerns have still been raised about the nature of the relationship between these two parties.

The challenges we face are about the partnership between industry and physicians. The importance of both sides committing to change and acting on changing regulations has been raised by others. With the increasing desire of industry to act within a modern ethical framework, the actions, not just the moral ideals of physicians, have never been more important. Both parties must take up the challenge to ensure that a dialogue occurs to find a mutually acceptable way forward.

In its report into the influence of the pharmaceutical industry, the House of Commons Health Select Committee stated that, “deciding when 'non-statutory excesses' are being undertaken and that their effects are against public interest is not an easy task”.

The old standard of providing entertainment at a level that a doctor could normally afford himself is now flawed. The justifications put to industry by senior healthcare professionals to this day include, 'As a consultant, it is only reasonable that I fly business class'. Perhaps it is time for both sides to think again and imagine what our patients would think.

Patients quite reasonably expect extremely high-quality medicines that deliver benefit with minimal risk. However, the explanation of risk/benefit remains a major challenge. Risk issues have increasingly come to dominate scientific and political discourse in the media. Beck explains this as modern states becoming risk societies. Evidence of this is seen in health-related risk discussions such as bovine spongiform encephalopathy, genetically modified food and the measles, mumps, rubella (MMR) debate. Increasingly, we are seeing society changing its position and becoming far more risk averse in many aspects of life, public transport, food hygiene, car safety etc. Consequently, one of the major challenges facing all physicians is the difficulty in explaining risk/benefit to patients. This concept is at the core of physicians' decisions and is a crucial element in industry-produced medical education materials. However, it is challenging for physicians and industry to convey messages in ways that are meaningful and useful to the general public.

There have been high profile allegations in the past where industry has been accused of failing to disclose data to inform this risk/benefit discussion. However, it is important to put these rare allegations into context. Industry has started to address this issue by increasing transparency in the important area of clinical trial data. An example of this is the establishment of the Clinical Trials Register; a register that places all trial data in the public domain (Box 1).

Box 1: Clinical Trials Register

In 2005, major companies in the pharmaceutical industry agreed proposals that a ...