E-DRUG: Need for cough mixtures (cont)
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Dear E-Drug Members
Firstly, as we all know the efficacy of cough mixtures is a contentious
issue. However this is not the point of my reply. I feel that the e-drug
forum should not be used for "market-type research" for the benefit of
the pharmaceutical industry or any independent consultant. This data
has a "price" attached to it in any industry setting. Should this data be
needed there are conventional methods for data collection - granted
though this may cost the consultant/industry money!! To imply that
the cough mixture is for potential sale in "primary care" is merely a
guise to detract from standard profit making. Also, passing SA MCC
clearance of a product does not mean that it automatically becomes
listed as an essential drug or a contender for use in Primary Health
Care settings. I would ask that the e-drug forum remains focused on
supplying or gathering drug information for the benefit of health care
providers/EDP/NDP policy makers.
Yours sincerely,
Jacqui Jooste
--- Note from the moderator:
We received some more complaints about the commercial background of this
message. E-drug should indeed not be used for commercial gain.
There was a discussion with the people involved about this posting, and I had
recommended they discussed in E-drug the question whether it is worse to have a
placebo cough mixture than no cough syrup at all. Of course cough syrups don't
have proven efficacy, but with the enormous pressure of patients on health
workers there would be a danger that (in the absence of a placebo cough
mixture) health workers would dispense 'real' drugs like salbutamol syrup.
For everybody's background: Simple Linctus BP is on the 1996 SA Ess Drug List
for primary care, as the EDL Committee was of the opinion that they better have
a placebo rather than none (with the risk of misusing salbutamol etc).
Simple Linctus BP was, however, not yet registered, and due to the citric
acid/sugar content the Medicines Control Council has decided that it is unsafe
for the children's teeth. As Simple Linctus is not registrable, it will have to
be changed for a more acceptable placebo cough syrup in the next EDL. That's
why industry in SA is trying to find an 'acceptable' formulation of a
non-harmful placebo cough syrup.
I propose that the following issues be discussed in E-drug:
- Is it worse to have a placebo cough syrup or noting at all with the risk of
misuse of e.g. salbutamol syrup by health workers?
- What formulation would be the 'best' placebo cough syrup?
- What experiences are available in trying to reduce the demand for cough syrup
among patients, and have they managed to avoid alternative misuse?
Wilbert Bannenberg, E-drug moderator
Email: 73377.3055@compuserve.com
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