Crappy Branded Stuff

It has been many years now since ABPI introduced a new Code that put an end to the ‘gifting’ of relatively low value merchandise to healthcare professionals from industry representatives.

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In 2013, realising that this “crappy branded stuff” was disappearing I sought help in gathering an informal archive.

This Seroxat lamp is paradoxically symbolic – as science needs light. Without such light science cannot be assumed to be science:

In a similar consideration, it concerns me that the archive of the British Journal of Psychiatry  does not include the full-page glossy adverts that appear in every monthly edition. However, by mistake, one edition of the British Journal of Psychiatry from 1997 was archived with its adverts. To this very day full-page adverts like this feature in each monthly edition of the Journal:

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Recently there was a fascinating and open exchange on social media about such marketing to healthcare professionals.  Professor Wendy Burn, President of the Royal College of Psychiatrists, was part of this exchange, and like all contributors her thoughts were most welcome:

‏President of the Royal College of Psychiatrists: 
“Things have changed. When I started in Psychiatry we would accept gifts and meals from pharma. A few people didn’t and were thought to be odd. Now our members don’t like seeing sponsorship at our meetings. I haven’t seen anyone from Pharma since I started as President.”

“I never look at adverts for drugs. The ones on the TV in the USA are weird, hard to avoid those.”

“Just checked my pens. One from etc.venues and one from RCGP (honestly come by I’m sure).”

Contributor:
“Pharma logos on pens, or no pharma logos on pens are red herrings – it’s the systemic corruption of psychiatry by the pharmaceutical industry that is most concerning… surely you cannot deny that this is a problem”

‏President of the Royal College of Psychiatrists: 
“I don’t feel corrupted. But accept there have been bad behaviours in the past. This is not just Psychiatry.”

Contributor:
“If you are referring to other medical specialties, I agree – many of the other specialties are also corrupted, however that doesn’t mean it’s ok does it? just because all the other specialties take Pharma cash doesn’t make it ok for everyone to do it does it?”

“Things have not changed Wendy, most of your key opinion leaders are in the pocket of Pharma through honoria, research grants, talks they give etc etc. This is corruption, and it is ‘legal’ bribery.”


A few of my thoughts:
The current President of the Royal College of Psychiatrists acknowledges concerns about marketing, but only in terms of “the past”. We have had similar casual reassurances from the current and previous Chief Executive Officers of the Royal College of Psychiatrists, who have used words such as “yesteryear” to describe any relationship with industry. Indeed Vanessa Cameron, on her retirement as CEO in December 2016 described British psychiatry’s relationship with industry as “puritanical”.

Vanessa-Cameron, July 2016, Royal College of Psychiatrists, Pharma

In June of this year, the current Chief Executive Officer for the College, Paul Rees, gave the following firm assurance:

8-june-2018-rcpsych-our-policies-on-declarations-of-interest-are-already-sufficiently-robust

Here are some of the ‘key opinion leaders’ in British Psychiatry, a relatively small group who have very wide influence on prescribing practice. It remains impossible however to know how much they are paid. We have no way of knowing how much of the £42 million that the pharmaceutical industry pays each year for marketing their products may go to them.

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Paula J. Caplan stated in her consideration of the marketing of Risperidone:

“The details included finding ‘key opinion leaders’ who were prominent professionals in powerful positions . . . and having them teach Continuing Medical Education that professionals are required to take . .”

It seems to me that my College is demonstrating willful blindness on this issue. I would urge my College and all the other Royal Colleges, and the General Medical Council to support the immediate introduction of sunshine legislation.

This week I was reminded by the Chief Executive Officer of the Royal College of Psychiatrists that I was expected to follow the College Code of Conduct.   

Perhaps there is a glimmer of light in Psychiatry HQ, but if there is not enough light, I am happy to gift HQ my Seroxat lamp.

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