DUNCAN BRIAN =
DOUBLE=20
| View/Change=20
User Information | Email=20
alerts | Sign=20
Out |
Published 4 February 2009, =
doi:10.1136/bmj.b442
Cite=20
this as: BMJ 2009;338:b442
News
Individual drug firms should stop paying for medical education
Zosia Kmietowicz
1 London
All educational links between individual drug companies and = the=20 medical profession should cease, says a report from the Royal = College=20 of Physicians. Gifts to doctors and medical students, = including food=20 and travel, should also stop "in the spirit of a more = balanced and=20 mutually respectful partnership," it says.
The report, which has been produced by a specially convened=20 multisector working party, has examined the relationships = between=20 doctors, patients, the NHS, and the industry. Its aim is "to=20 rewrite the contract between patient care and industry in the = UK in order to improve national health outcomes," said = Richard=20 Horton, editor of the Lancet, who chaired the working = party=20 and was author of the report.
The report says that patients have lost confidence in the = prescribing=20 process because of unequal access to drugs in the United = Kingdom=20 and the withholding of information about innovative drugs = that=20 could be available to them.
And patient care is unlikely to improve in the future unless = the=20 drug industry and the medical profession can find a way to = resolve=20 the tensions between them.
Trust between the NHS and the industry has broken down, it says. = Doctors are concerned that continuing professional = development=20 programmes are too dependent on funding from drug companies,=20 and the industry complains that ambivalence from the NHS and=20 academia blocks future innovation.
At the moment the drug industry pays for about half of all = postgraduate=20 medical education and sponsors some parts of undergraduate = courses.=20 But a deadline, say of five years, should end the practice,=20 says the report.
The working party, which includes members from medical academia, = the NHS, the drug industry, and patient groups, was convened = by=20 the royal college in September 2007.
Its report proposes a new era of medical education, with = undergraduate=20 courses fully financed by public money. Postgraduate medical=20 education should be paid for through the royal colleges and = the=20 Department of Health, it recommends.
In addition, the Association of the British Pharmaceutical = Industry=20 and its members should establish a pooled fund to invest in=20 medical education to "unlink financing from a single company, = diminishing the perception of undue commercial influence and=20 bias," says the report.
"The relationship [between the NHS and the drug industry] is=20 currently afflicted by several serious wounds, wounds that = are=20 leaving preventable scars on the body of UK health," said Dr=20 Horton.
"Patients=92 needs and expectations around medicines are = not being=20 met. The NHS is losing the vital input of industry in cutting = edge=20 medical research. Doctors suffer from a lack of NHS = investment in=20 their continuing education, allowing industry to fill a = critical=20 void. And the nature of the relationship between the NHS and = pharma=20 is too often, and wrongly, portrayed as negative and=20 unproductive."
The report makes 42 recommendations on patient care, = professional=20 education, research, culture, and relationships.
It says a new medicines technical advisory group should be = created=20 to produce a UK-wide drug strategy "to fulfil current unmet=20 clinical need for prescription drugs and to remove = inequalities=20 in medicines provision across Britain." The multidisciplinary = group "could defuse conflict, provide a forum for = constructive=20 discussion, enhance transparency, and build trust."
The report says, "This kind of collaboration would simply scale=20 existing local collaborations up to national level, to plan=20 services countrywide between the NHS and the pharmaceutical=20 industry."
Among the working group=92s other recommendations is a = comprehensive=20 information strategy for patients, which should include = independent=20 sources of evidence about prescription drugs and diseases and = a=20 patient=92s version of the British National Formulary. =
Education for medical students on how drugs are developed and=20 regulated, pharmacovigilance, and safer prescribing should = also=20 be strengthened.
The royal and academic colleges are called on to lead "with = a=20 stronger voice," to support research collaborations between = industry=20 and the NHS, to devise incentives for NHS bodies and doctors = to take=20 part in research, especially clinical trials, and to = "challenge the=20 increasing regulatory bureaucracy that is eroding the UK=92s=20 competitive edge in clinical trial research."
"The intention is that the recommendations contained in the = report=20 will enable clinicians, academia, industry and the national = agencies=20 . . . to create a climate of trust and cooperation that = transcends=20 the interests of any one party," says Ian Gilmore, president = of the=20 college, in a foreword to the report.
"Getting the relationship between the NHS, academia, and the=20 industry right has the potential to deliver sustainable = advances=20 in patient treatment, a really worthwhile prize," he said. =
The college plans to establish a pharmaceutical forum, which = will=20 include physicians, scientists, research funders, industry=20 representatives, editors, and patient groups. The group will=20 review progress in two years=92 time at a national conference = organised specifically for the purpose.
Richard Tiner, medical director of the Association of the = British=20 Pharmaceutical Industry, said: "The RCP [Royal College of = Physicians]=20 has taken a long, hard look at how doctors, academics and the = pharmaceutical industry work together, with a specific focus = on=20 what is in the best interests of patients. It has come back = with a=20 powerful report which highlights how the views of the = industry and=20 NHS are fragmented and sets out concrete and constructive=20 recommendations to get all sides pulling together.
"We welcome publication of the report, are grateful to have = been=20 asked to contribute to it and welcome the debate it ignites. = We will=20 consider all the recommendations very carefully and look = forward to=20 working with the RCP and others to see how they can be = progressed as=20 we believe a strong, united NHS family is in everyone=92s = best=20 interests."
Cite this as: BMJ 2009;338:b442
Innovation for Health: Patients, = Physicians, the=20 Pharmaceutical Industry and the NHS is at
Read all Rapid=20
ResponsesRelevant Article
BMJ 2009 338: b463. Rapid Responses:
bmj.com, 12 Feb 2009
This Article
![3D"Freely](3D"http://www.bmj.com/icons/shared/toc/free.gif")
=20
- PDF of=20 print issue=20
- Respond=20 to this article=20
- Read = responses=20 to this article=20
Services
- Downloa= d=20 to citation manager=20
Google Scholar
PubMed
Related Content
- Patients
Bookmark with
What's new
Latest blogs
Find BMJ on:
Services
- Blogs=20
- Podcasts=20
- Video=20
- Submit an article=20
- Subscribe/Activate=20
- Email = alerts=20
- Request = permissions
Tools
Online poll
Resources
- Readers=20
- Authors=20
- Reviewers=20
- Media=20
- BMA = members=20
- Advertising and = sponsors=20
- Subscribers =
Rapid responses for this article
Print issues
![](3D"http://www.bmj.com/home/icons/bmjh_current_cover.jpg"){kind=icon}
=