An influential UK government committee has called for tougher regulation of the pharmaceutical industry. In a report, "The
Influence of the Pharmaceutical Industry," issued last month, the House of Commons' Health Select Committee, made up of members
of Parliament, claims that the industry has been over-promoting its products and hiding bad results of clinical trials. While
acknowledging that the pharma industry has produced many life-saving medicines and made a great contribution to healthcare,
the Committee believes drug companies have become increasingly focused on marketing.
It also has harsh words for the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), claiming that
it lacks the "discipline and leadership needed to protect patients' health needs." Another attack was reserved for the lack
of transparency in the industry's funding of patient groups, which frequently call for a more widespread use of new medicines.
Finally, the report claims that doctors are "sometimes too willing to accept hospitality from the industry and act uncritically"
on the information the industry provides.
The report flies in the face of the government's current thinking, which is to use a lighter touch with the industry. On the
contrary, the Committee's chairman, David Hinchliffe, says public health would be best served if regulators used a stronger
"Drug companies need effective discipline and regulation, and these have been lacking," said Hinchliffe at the time the report
was launched. "The pharmaceutical industry is extremely powerful and influences healthcare at every level. We have developed
an over-reliance on medicines. They have been over-prescribed, and patients have suffered as a result."
The industry's response to the report is somewhat mixed. The Association of the British Pharmaceutical Industry has welcomed
some parts—particularly, the report's call for improved side-effects monitoring and reporting, and for publishing information
about patient group funding and the financial benefits the industry gives to doctors; the association also agrees with a move
for improved new drug information for patients.
But it strongly disagrees with much of the rest of the report. First, the report asserts that the United Kingdom has a vast
and increasing consumption of drugs. "Not so," says the Association's current president, Vincent Lawton, managing director
of Merck Sharp & Dohme. "We have one of the lowest spends on medicines in Europe," he claims. "We have the slowest uptake
of medicines in Europe in the first five years after launch, and not the prescribing 'explosion' following launch, as was
stated by the Committee."
Lawton also refutes the notion that intensive marketing encourages inappropriate prescribing. "The reality [is] that four
out of five doctors choose to see between just one and four reps per month," he says. "More importantly, they value the clinical
and product information that the reps provide for them."
Thirdly, Lawton claims that a number of the Committee's recommendations would restrict information to prescribers, and restrict
prescribing freedom. "Other recommendations would introduce yet more hurdles for new medicines' acceptance at the local level,"
he says. "We believe the only loser would be the patient."
A full response from the government will be published in the next few months. Health Minister Lord Warner says he believes
government has an effective and proper working relationship with an industry that contributes a great deal to the health and
wealth of the UK.
"Government and industry should view this as an opportunity to address the public concern that this inquiry reflects, about
the lack of transparency in some of the current systems and processes," Warner says. "Rightly or wrongly, that perception
makes the public think that things are being hidden from them."
He cites actions that have already been taken: instating memberships of safety of medicines bodies, and directly notifying
patients about adverse drug reactions. "But some parts of the industry have to do better on public clinical trials data on
a voluntary basis, or government will be forced to act," Warner says.