E-drug: Advertising in national formularies (cont)
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Hi all
It seems that most countries follow the same line here - there are
commercially funded compendia (MIMS, PDR), with some linkage
between what is listed there and the approved indications/warnings
etc (these would be considered as advertising, so most legal
systems would limit the company's message to what has been
accepted as proven by the regulatory authority, but as Joel Lexchin
points out, this might be affected by the time that has elapsed
between registration and the placement of the "advert"). Then there
are the supposedly independent providers, hopefully giving
clinicians comparative information and commentary on such
problem areas as cough and cold preps, and free from commercial
influence - an example would be the South African Medicines
Formulary (SAMF - a previous edition, unfortunately not the latest,
the 5th, is available at www.uct.ac.za/depts/pha/samfhtml.htm).
The SA EDL/STG sets also don't contain adverts (see
www.sadap.org.za/edl/ ).
However, I'm always a touch wary of simple analyses of this
"problem" - in resource-poor settings there is often insufficient
funding for "independent" sources of drug information. Let's look a
bit more closely at the SAMF - the book is produced by the Dept of
Pharmacology at the Univ of Cape Town medical school. However,
the "product" belongs to the SA Medical Association, which relies
to some extent on the revenue obtained from selling the book (even
at a very reasonable price). The current edition was produced with
the help of an "educational grant" from the Medical Protection
Society. Does the "commercial" nature of these organisations
make the product "tainted", or is this contagion only applicable if
the sponsor/advertiser is a pharmaceutical manufacturer?
Among the contributors/consultants to the SAMF are members of
the staff of the Medicines Information Centre, located within the
Dept of Pharmacology. This centre is supported by a grant from a
pharmaceutical manufacturer. Does even that tenuous link
somehow "contaminate" the product?
I would suggest that instead of accepting a simple delineation
between "independent" and "commercial" sources of information,
we instead focus on empowering health workers to be ever-vigilant
about potential conflicts of interest, to be advertising-literate (able
to critically examine the "evidence" presented), and that we put in
place the necessary safeguards, checks and balances to ensure
that "unrestricted educational grants" are indeed unrestricted, while
ensuring that the most efficient use is made of all available
resources. Among those resources, which can be put to good and
careful use, are the resources of the pharmaceutical industry. We
can't wish them away, but we can work with them and ensure that
their marketing activities are effectively regulated.
regards
Andy Gray
South Africa
"Andy Gray" <agray@pixie.udw.ac.za>
[Please Andy supply your physical address and affiliation. BS co-moderator]
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