The recent proposals for European legislation contained in the delayed “pharmaceutical package” outline that pharmaceutical companies may be given permission to provide “information” regarding their prescription medicines in Europe [1] presents a troubling prospect for the future of objective prescription, usage and funding of medicines.

Thankfully, the ban on direct-to-consumer advertising (DTCA) stands and pharmaceutical companies will not be granted the untrammelled access to consumers they enjoy in other countries. As is widely known, this sort of engagement with consumers has not always benefit patients: consider the case of Vioxx in which strong patient interest generated in the drug by its producer Merck translated into “blockbuster” status. Merck’s later withdrawal of the drug came after perhaps thousands of preventable adverse events.[2]

Monitoring is obligatory and will be carried out by Member States, prior to dissemination. However, the industry has found its way around monitoring systems before: the Food and Drug Administration’s (FDA) vetting of US pharmaceutical advertisements has for instance has often been ineffective, resulting in dissemination of false and misleading advertising material, [3] [4].

Patients require unbiased and objective information, and have the right to the highest quality of information about their health. As it stands though, the description of “information” in the EC proposals is inadequate and may come with some of the negative side effects of direct to consumer advertising. The profile of profitable branded drugs may be increased which will ramp up prescription medicine spending by patients and the NHS. Unbiased and objective information would be best provided by healthcare professionals, who are trained to appraise and interpret the evidence on clinical and cost effectiveness.

Healthcare professionals are increasingly aware of the potential conflicts of interest in having close ties with the pharmaceutical industry and its subsequent impact on patient safety and care. [5][6]. It would be very unfortunate if the influence of the pharmaceutical industry’s marketing apparatus instead refocused onto patients, perpetuating the industry’s influence yet longer. We call upon the European Commission to abandon its proposals and explore options for a more impartial and unprejudiced system of high quality peer-reviewed information provision.

[1] Watson R. Proposal to allow drug companies to give information to public sparks outcry. BMJ 2008;337:a3043

[2] Topol EJ. Failing the public health - Rofecoxib, Merck and the FDA. NEJM 2004; Volume 351:1707-1709.

[3] Prescription drugs: improvements needed in FDA’s oversight of direct- to-consumer advertising. Washington, DC: Government Accountability Office, November 2006.

[4] Angell M. The truth about drug companies. New York: Random House, 2004.

[5] Sweet M. Australian health professionals warned against featuring in advertisements. BMJ 2008;337:a2951

[6] Brennan TA, Rothman DJ, Blank L, Blumenthal D, Chimonas SC, Cohen JJ, Goldman J, Kassirer JP, Kimball H, Naughton J, Smelser N. Health industry practices that create conflicts of interest. JAMA. 2006;295:429-433.

Jonathan A Currie, Helen Preston, Sudath Weerapperuma

Competing interests: HP is President of Medsin, a student global health network. JC is Campaigns Director of Medsin. Sudath Weerapperuma is a representative of Pharmaware, a UK campaign aiming to maximise ethical interactions between healthcare professionals and pharmaceutical companies. We declare that we have no conflicts of interest.