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Healthy Skepticism Library item: 2985

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: media release

Harvey K.
Submission to ACCC re: Application A90994-6 by Medicines Australia re revised Code of Conduct [15th Ed]
Medreach ( ) 2005 Dec 14



Ralph Faggotter’s Comments:

Medicines Australia wishes to revise their ‘Code of Conduct’ and has submitted a revised code to the ACCC (Australian Competition & Consumer Commission) for approval.

The ACCC has called for submissions by interested parties to comment on the proposed new Code.

The relevant document can be found on the ACCC webstie at-

Presented here is the response of Dr Ken Harvey, Healthy Skepticism member, to the ACCC invitation.

Healthy Skepticism will also be providing a submission.
We encourage other Healthy Skepticism supporters to provide their personal submissions.

Full text:

Submission to ACCC – re: Application A90994-6 by Medicines Australia re revised Code of Conduct [15th Ed]

The General Manager
Adjudication Branch
Australian Competition & Consumer Commission
PO Box 1199

Re: Application A90994-6 by Medicines Australia re revised Code of
Conduct [15th Ed]

Dear Mr. Gregson,

I write in response to your letter dated December 5, 2005. I ask that
interim authorization of Medicines Australia Code NOT be allowed on the
grounds that this would give prima facie approval to a self-regulatory
Code that is fundamentally flawed in its revision process, content and

For example:

Medicines Australia Code revision process only involves consumer,
medical and government organisations / departments that have an intimate
and often dependent relationship with the pharmaceutical industry. It
excludes organisations such as the Australian Consumer’s Organisation
and the Doctor’s Reform Association which have a specific policy of
independence from the pharmaceutical industry. The end result is a
“self-regulatory” process that is self-serving to vested interests
rather than the public health.

Despite considerable published concern [1-2] about the recent
infiltration of pharmaceutical promotion onto GP’s computer screens
(which patients are encouraged to share) new content in the 15th Edition
has only produced cosmetic rather than substantive amendments to the
Code in this area (see 3.9.1). Other areas of concern, such as mandating
standards to ensure the legibility of generic names (by insisting that
they have the same size, font, color and background as a brand name on
computer screens of varied resolution) have also not been adequately
addressed (see 3.9.7).

There has been publicly expressed concern that management of Code
breaches by Medicines Australia has failed to deter unethical behavior
by the pharmaceutical industry as evidenced by the fact that many
pharmaceutical companies repeatedly breach the Code, probably because
the fines imposed are minuscule in relationship to the money gained from
promotional excess (and Code breaches). These concerns have also been
ignored in the latest Code revision.

The end result is a Code which encourages inappropriate demand and
prescribing of heavily promoted drugs that is often not in accord with
cost-effective best-practice. This is one reason why the cost of the
Pharmaceutical Benefits Scheme has increased exponentially over the last
decade (at about 11% per annum, twice the increase of medical or
hospital services). In response, the government has recently introduced
large increases in co-payments and safety-nets (transferring more of the
costs of the PBS from government to consumers) which have inevitably
resulted in poorer consumers forgoing necessary medicines to the
detriment of their health.

Given the above, my response to your specific questions are as follows:

1. Is the Code effective: No!

2. Should parts of the Code be amended: Yes.

3. Will public benefits flow from granting immunity to the Code: Not
until it is substantially improved.

4. Does the Code result in detriment to competition or the public: No
detriment to competition but certainly detriment to the public health
and public good!

A more complete analysis of the deficiencies of Edition 15 of Medicines
Australia Code and Medicines Australia self-regulatory system will be
provided by January 20, 2006. Meanwhile, I have provided some additional
references that may assist the ACCC in its deliberations on this matter.

In conclusion, I reiterate that interim authorization should NOT be
allowed on the grounds that this would give prima facie approval to a
self-regulatory Code that fails to address well publicized problems and
is currently causing consumer detriment.


1. Ruff TA, Haikal-Mukhtar H. Doctors, drugs, information and ethics: a
never-ending story. MJA 2005; 183: 73-7.

2. Harvey KJ, Vitry AI, Roughead E, et al. Pharmaceutical advertising in
prescribing software: an analysis. MJA 2005; 183: 75-79.

3. Komesaroff PA, Kerridge IH. Ethical issues concerning the
relationships between medical practitioners and the pharmaceutical
industry. MJA 2002; 176: 118-121.

4. Breen KJ. The medical profession and the pharmaceutical industry:
when will we open our eyes? MJA 2004; 180: 409-410.

5. United Kingdom House of Commons Health Committee. The influence of
the pharmaceutical industry. London: Stationery Office, 2005.


Dr. Ken Harvey
School of Public Health
La Trobe University Mobile +61 0419 181910

Dr. Ken Harvey Mobile +61 0419 181910


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