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Healthy Skepticism Library item: 19615

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

Sukkar E
European industry group publishes code on medical conferences
BMJ 2011 Aug 12; 343:

Full text:

The European drug industry has created a grading system for medical education
conferences to help steer drug companies away from sponsoring or participating
in those that are considered lavish or inappropriate.

The database, available on, was set up by the European Federation of Pharmaceutical Industries and Associations (EFPIA).

José Zamarriego, head of the code of practice surveillance unit at Farmaindustria,
the Spanish industry association, has worked closely on the project for the
past eight months. He said, “One of the aims of the scheme is to help the
pharmaceutical industry build trust and credibility with healthcare
professionals through transparency. It is one step forward.”

The database has assessments of more than 100 upcoming conferences, and a further
250 events are to be assessed by the end of the year. For now the federation is
assessing only international events taking place in Europe that it considers
“major”—those in which healthcare professionals of more than
five countries may take part and that are expected to attract more than 1000
participants. But in future it may look at smaller meetings.

A spokesperson for the European commissioner for health and consumer policy told
the BMJ that the European Commission welcomed any attempt by the industry to
comply with European Union legislation and to “define clear rules and
improve transparency.”

Birgit Beger, the secretary general of the Standing Committee of European Doctors,
which represents 27 European medical associations, said that the initiative was
an industry attempt to comply with EU and national legislations and an
“effort to improve transparency.”

Nevertheless the European Cancer Organisation, which has 24 oncology member associations, is
concerned with the rating it got for its upcoming congress on cancer, the
largest held in Europe. It has criticised the methods used by EFPIA, saying
that it relies on website searches rather than contacting organisers directly.

Each event is assessed in five different areas, including the event’s
scientific programme, the hospitality provided, and the location, with each area
receiving a colour code, green, orange, or blue. Green means that the
event’s arrangements “would not raise concern” with respect
to EFPIA’s code on interactions with healthcare professionals and the
promotion of prescription only drugs to them, but orange means that
arrangements “may raise concern.” Blue means that aspects of the
event are still under review by EFPIA.

An assessment does not produce a single composite colour, as EFPIA “wants to
give companies advice, rather than issue an outright ban for participating in
any particular conference,” said Dr Zamarriego, whose own association
operates a similar model, but which contains a red category.

An academic who writes about companies’ drug promotion activities believes
that EFPIA’s rating scale has a “major problem,” as it lacks
a “red light.” Barbara Mintzes, assistant professor in the
department of anaesthesiology, pharmacology, and therapeutics at the University
of British Columbia, said, “The lack of an overall rating does not
provide any guidance on whether EFPIA believes that the event should or should
not be sponsored.”

EFPIA’s new code is being applied through the code of each national industry
association. “It’s up to national bodies to police it,” Dr Zamarriego said.
Some events have received green codes for all five aspects
assessed, while others fare not so well on hospitality, receiving an orange
code. Dr Zamarriego said, “We have a lot of greens. There are some
oranges, which is a concern, mostly on entertainment.”

Dr Mintzes described the project as “a very small baby step in the right
direction” for the industry. She believes that it is unlikely to make
much of a difference, if any, because of other promotional activities by the
industry that may affect doctors’ prescribing, such as promotion of drugs
in scientific and educational activities and gifts to health professionals,
including hospitality and subsidies for travel to conferences.


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There is no sin in being wrong. The sin is in our unwillingness to examine our own beliefs, and in believing that our authorities cannot be wrong. Far from creating cynics, such a story is likely to foster a healthy and creative skepticism, which is something quite different from cynicism.”
- Neil Postman in The End of Education