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A Parliamentary Health Committee is currently investigating the
influence of the pharmaceutical companies (1). Its now established that
there is a correlation between drug sponsored studies and favourable
results for both clinical outcome (2) and economic analysis (3) and the
picture is further complicated by selective publishing (4). Even small
gifts can influence doctors’ behaviour (5). Pfizer recently pleaded
guilty for promoting off-label use of gabapentin, often used in bipolar
disorder, in the absence of any evidence of efficacy (6). In psychiatry,
the problem of definition and validation of illness means that the field
is arguably more open to commercial interest and manipulation than other
areas of medicine (7) and unlike other branches of medicine patients may
be compelled to take medication against their consent. The Critical
Psychiatry Network (8) conducted an audit of all 83 Mental Health Trusts
in England as to whether they had a policy concerning links between
professional and the pharmaceutical companies. There were 68 replies
(82%). 36 (53%) had a current policy with a further 8 (12%) considering a
draft policy. In spite of the high profile now afforded to the issue it
is surprising that only a half of Mental Health Trusts have a policy on
the issue.
2. Safer DJ 2002 Design and reporting modifications in industry sponsored
comparative psychopharmacology trials. Journal of Nervous and Mental
Disease. 190, 583-592
3. Baker CB, Johnsrud MT, Crimson ML et al 2003 Quantitative analysis of
sponsorship bias in economic studies of antidepressants. British Journal
of Psychiatry. 183, 498-506
4. Melander H, Ahlqvist-Rastad J, Meijer G & Björn B 2003 Evidence
b(i)ased medicine. Selective reporting from studies sponsored by
pharmaceutical industry: review of studies in new drug applications. BMJ
326 1171-1173
5. Studdert DM, Mello MM & Brennan TA 2004 Financial conflicts of
interest in physicians’ relationship with the pharmaceutical industry.
Self-regulation in the shadow of federal prosecution. The New England
Journal of Medicine 351 1891-1900
6. Lenzer J 2004 Pfizer pleads guilty, but drug sales continue to soar.
BMJ 328, 1217
7. Moncrief J, Hopker S & Thomas P 2002 The pharmaceutical industry
and disease mongering. BMJ 325 216
Links between Mental Health Trusts and Pharmaceutical companies: Audit of local policy.
A Parliamentary Health Committee is currently investigating the
influence of the pharmaceutical companies (1). Its now established that
there is a correlation between drug sponsored studies and favourable
results for both clinical outcome (2) and economic analysis (3) and the
picture is further complicated by selective publishing (4). Even small
gifts can influence doctors’ behaviour (5). Pfizer recently pleaded
guilty for promoting off-label use of gabapentin, often used in bipolar
disorder, in the absence of any evidence of efficacy (6). In psychiatry,
the problem of definition and validation of illness means that the field
is arguably more open to commercial interest and manipulation than other
areas of medicine (7) and unlike other branches of medicine patients may
be compelled to take medication against their consent. The Critical
Psychiatry Network (8) conducted an audit of all 83 Mental Health Trusts
in England as to whether they had a policy concerning links between
professional and the pharmaceutical companies. There were 68 replies
(82%). 36 (53%) had a current policy with a further 8 (12%) considering a
draft policy. In spite of the high profile now afforded to the issue it
is surprising that only a half of Mental Health Trusts have a policy on
the issue.
References.
1.
http://www.parliament.uk/parliamentary_committees/health_committee/hc180...
2. Safer DJ 2002 Design and reporting modifications in industry sponsored
comparative psychopharmacology trials. Journal of Nervous and Mental
Disease. 190, 583-592
3. Baker CB, Johnsrud MT, Crimson ML et al 2003 Quantitative analysis of
sponsorship bias in economic studies of antidepressants. British Journal
of Psychiatry. 183, 498-506
4. Melander H, Ahlqvist-Rastad J, Meijer G & Björn B 2003 Evidence
b(i)ased medicine. Selective reporting from studies sponsored by
pharmaceutical industry: review of studies in new drug applications. BMJ
326 1171-1173
5. Studdert DM, Mello MM & Brennan TA 2004 Financial conflicts of
interest in physicians’ relationship with the pharmaceutical industry.
Self-regulation in the shadow of federal prosecution. The New England
Journal of Medicine 351 1891-1900
6. Lenzer J 2004 Pfizer pleads guilty, but drug sales continue to soar.
BMJ 328, 1217
7. Moncrief J, Hopker S & Thomas P 2002 The pharmaceutical industry
and disease mongering. BMJ 325 216
8. www.criticalpsychiatry.co.uk
Competing interests:
Dr R Huws is secretary to the Critical Psychiatry Network
Competing interests: No competing interests