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Monday, June 16, 2008

excerpts of the UK Parliament review

From the review "The Influence of the Pharmaceutical Industry":

Professional and patients Education p.25

74
. Education for patients is provided in a variety of ways, including disease awareness campaigns, which are discussed in detail in Part 8.Such campaigns are designed to increase awareness among the general public of particular conditions that may be under-reported or under-diagnosed and to encourage people to seek treatment. Often, such campaigns are sponsored by a drug company and may bear a company ’s logo they may be also endorsed by a charity or patient organization and/or supported by a celebrity. P. 27

The promotion of Drugs

77. Prescription-only medicines may be promoted only to healthcare professionals, except in very specific cases such as Government-endorsed vaccination programmes. Promotion to prescribers may take many forms:

a) Drug company representatives. Approximately 8,000 drug company representatives operate in the UK and play an important role in information provision and. Many doctors cite them as one of the main sources of information on the use of new drugs.56 p.27/28

79. A critical element of the work of medical communications companies is the recruitment and training of key opinion leaders (KOLs), who are usually ‘authoritative third parties ’ such as physicians at the top of their field. These individuals may be paid to speak and write on behalf of the sponsoring pharmaceutical company. They attend medical conferences, for example, and may present research papers, take part in panel debates or field questions in oral sessions. The ' development' of KOLs, we were told, is a well-worked process involving all types of doctors (hospital consultants, clinical academics and GPs). P. 29

84. The direct advertising of prescription drugs to patients is prohibited. Direct-to-consumer advertising (DTCA) of prescription-only medicines is permitted only in the US and New Zealand. p. 29

248…Dr Spence was especially concerned about the ‘Defeat Depression Campaign ’ and its effect on prescribing patterns and the public ’s perception of depression: [That campaign ] led to us being told that a third of people were depressed, that we should screen for it, that we should start using antidepressants early, and we did. If I think back five or ten years ago, we were diagnosing large numbers of people with depression, and we were prescribing many antidepressants. As time has gone on, I have certainly begun to realize that in some ways yes, there are many people who do have depression, but lots of people are just unhappy and that is a part of life. So there is a whole generation of people coming up who almost feel that being unhappy is and abnormal state, which, of course, it is not.210 p. 71/72

249.The ‘Defeat Depression Campaign ’ ((1992 –1997),which was run through the RCGP and the Royal College of Psychiatrists, and sponsored by the manufacturers of antidepressants (who provided approximately one-third of the funding)targeted doctors as well as patients, in particular to emphasize that these drugs did not cause addiction or dependence. These claims have since been disputed and a warning about withdrawal symptoms is now included in the SPC. The Royal College of Psychiatrists provided supplementary evidence emphasizing that the Defeat depression Campaign had been intended to make it clear “that antidepressant treatment was not appropriate for mild to moderate depression, but effective only for severe or clinical depression ”.211 This important message evidently got lost; indeed there remains much confusion on this point today.212

The Royal College also told us it had recently reviewed its policies on accepting commercial sponsorship, and now aims to keep total income from these sources at around 5%of the College's annual turnover. Commercial sponsorship accounted for under £500,000 (5.5% on turnover of £9m) in 2003. p. 72

The concept of ‘genetic predisposition to disease’ is therefore one that has gained widespread acceptance in recent years. However, being genetically predisposed to a disease does not mean that it will actually develop – there is an environmental component that interacts with other biological factors, such as the presence of particular disease antibodies.

According to GeneWatch:

Increasingly, medication is now prescribed to reduce risk of future illness. Selling medication to treat risk factors rather than diseases is immensely profitable for the pharmaceutical industry: or example, statins (to lower cholesterol levels) are now the biggest selling prescription drugs in the world [and are also now available over the counter ]220 p. 75

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