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Healthy Skepticism Library item: 20251

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

Saying 'no thanks' to the pharmaceutical industry's undue influence
Prescrire 2012 July 23;


In a published response to Andrew Jack’s article “Mea culpa: are multi-billion dollar fines forcing drug companies to clean up their act?” (BMJ online, 18 July 2012), Prescrire points out that the need to root out undue influence does not stop there.
Certainly, the medical profession should clean up its act, as suggested in the feature on illegal promotion of antidepressants by GSK (1), but so should health authorities.
Recent drug disasters, such as the Mediator° (benfluorex) fiasco in France, are testament to the harmful effects of conflicts of interest at the institutional level (2).
Not surprisingly then, as French prescribers have gained greater awareness of drug marketing practices (3)(4), they have adopted a critical stance towards pharmaceutical companies’ promotional activities (5); and some 19 000 of them have responded by seeking out, and paying for, their own independent information and continuing education from reliable sources, such as the French journal La Revue Prescrire (6) (Table 1). Prescrire is entirely financed by its subscribers; there are no grants, no advertising, no shareholders and no sponsors.
Table 1: Breakdown of paying subscribers to La Revue Prescrire
Occupation September 2010 September 2011
Number % Number %
General practitioners 14 368 49.3% 16 857 48.7%
Specialists 1 480 5.1% 1 996 5.7%
Pharmacists 5 909 20.3% 6 872 19.8%
Others 7 345 25.3% 8 947 25.8%
Total circulation 29 102 100% 34 642 100%
Why? Because access to independent, reliable data is essential for making informed decisions, with patients, about various treatment options. Critical appraisal of ‘official’ clinical guidelines from an evidence-based perspective is also relevant (7).

While many might still accept the advances of the pharmaceutical industry, one should not underestimate the growing number of healthcare professionals who opt to pay for their own continuing education and who reply “no thanks” to industry’s attempts to win them over (the cost of which ends up being paid for by patients and society at large).


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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909