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Healthy Skepticism Library item: 16852

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Jundi O
The Pharmaware Annual General Meeting
The Lancet Student 2009 Dec 7;


Pharmaware is a UK-based student campaign which aims to maximise good practice and ethical interactions between healthcare professionals and pharmaceutical companies. Omar Jundi, a final year medical student from Leeds, recounts his experience of their recent Annual General Meeting.

Never let it be said that Pharmaware is opposed to free lunches: it’s conflicts of interest that we’re opposed to. This is what I kept telling myself as I sat hunched over my living room coffee table, spreading butter onto a seemingly endless flow of sliced bread. Charged with the task of organising lunch for the AGM, my unsuspecting friends and I were well into the food preparation process. They were keen to highlight the irony of providing food for free at a Pharmaware Annual General Meeting (AGM).

As an organisation that targets the interactions between the pharmaceutical industry and the medical profession, Pharmaware is often labelled as a ‘No Free Lunches’ campaign. But as I wrapped the final turkey salad sandwich, and allowed my weary sandwich makers to rest, I wondered if seeing this giant pile of free food would change people’s minds. The next morning, sandwiches in laps and armed with a video camera, we set off to the University of York, where the AGM was to be held. I was a little nervous, as the prospect of running a discussion and a talk weighed heavily on my mind, but on our arrival I soon became settled. It was a small AGM; around 20 people had turned up, but that suited me fine. The atmosphere was relaxed, and as far as I could tell, everyone seemed to be getting along well.

The speakers

The first speaker was Professor Alan Maynard, an expert on Health Policy and Economics. His fasinating talk delved into the complex world of drug approvals, NICE guidelines and the way drugs are licensed in the UK. The way he described these complicated systems in clear, understandable terms showed this was a man who understood his field very clearly. He highlighted many flaws with the system; the long approval system, the obligatory nature of NICE guidelines, and the application of national standards on regional Primary Care Trusts (PCTs). One example was the use of Quality-Adjusted Life Years (QALYs). As far as NICE is concerned, any drug that costs less than £30 000 for every year of good health that it adds to a patients life is cost-effective. But this is a lot more than many PCTs can afford, and by being forced to apply these guidelines, they often have to cut services in other areas. Professor Maynard felt optimistic that with a little bit of tinkering, a healthy dose of common sense, and perhaps by learning a few lessons from the Scottish Intercollegiate Guidelines Network (SIGN), NICE could be made more effective and appropriate.

Our next talk was an introduction to critical appraisal, an issue very dear to Pharmaware’s heart. One of the many fronts on which Pharmaware campaigns is getting more critical appraisal into medical school curricula, to better equip students to deal with the myriad of publications and evidence that is thrust our way from the pharmaceutical industry. Dr Steven Oliver led the session, and by talking through some of the more common flaws that arise in published articles, I feel a lot more comfortable campaigning for more teaching on the topic. I had often had a niggling thought in the back of my mind, that I shouldn’t be campaigning to be taught more about critical appraisal when I didn’t know much about it myself. Dr Oliver helped to allay those thoughts.

Merav Kliner, one of the founders of Pharmaware, went on to give an interesting talk about the way European Union policy is shaping up to change the way the pharmaceutical industry is regulated. This is becoming one of the major issues that Pharmaware campaigns on, and the inherent complexities associated with anything related to policy development in the EU make this an incredibly difficult topic to present clearly. Having just been to a Health Action International conference on this exact topic, Merav was more than able to give a clear, concise talk on the challenges we faced, the most important of which being the looming threat of direct-to-consumer advertising.

The event

Next came my moment to shine: lunchtime. We set off to the cafe, carrying the scrumptious-looking sandwiches that I had managed to resist eating for a whole morning. Martyn Stones, the Pharmaware member deserving of the most credit for the excellent organisation and smooth running of the AGM, had manage to procure a water boiler, which came in handy throughout the day. Over lunch and tea we all chatted about the issues raised through the day, and – as often happens at these events – I was hit by a strong motivation to push hard with our campaigning this year, to really enact change in the way we dealt with the pharmaceutical industry.

Professor Charles Lacey gave the final talk, in which he spoke about HIV, and the drugs used to treat it. It was interesting to hear the views of someone heavily involved in research, on the benefits and drawbacks of our relationship with industry, and he offered a pragmatic view of the changes needed to improve patient experiences. That talk was followed up with two brilliant discussions on dealing with the changing tactics of the pharmaceutical industry and how we should be engaging them. The first discussion focused on new means of marketing that industry uses, such as ghostrwriting, and the payment of Key Opinion Leaders to speak about, and endorse, their products.

Final remarks

We all came out in strong agreement that these practices were of no benefit to patients, of no scientific value, and may even put public trust in the medical profession in jeopardy. We agreed that a plan of action had to be formulated, and the campaign process is getting underway, starting by contacting various stakeholder groups, to gather their opinions on these issues.

The final discussion was more about the way we campaigned. Should we be engaging with the industries that we campaign about? It was felt overall that, while we should always consider the message that our actions send to those around us, there were benefits to interacting with the pharmaceutical industry in our campaigning process. I was left with the task of giving a short talk on the different campaigns that Pharmaware is currently involved in: Medical school curricula, critical appraisal teaching, conflict-of-interest policies and UAEM to name a few. I ended my talk with a big thanks to Martyn for organising the event, and everyone was soon free to have a fun evening in York.


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