Professor Warwick Anderson, the ceo of the NHMRC, thinks so. As reported in Crikey today, he’s suggested that doctors and other health professionals avoid appearing in advertising for pharmaceuticals or other health and medical products, and that they also steer clear of commercially driven disease-awareness campaigns.

Croakey is surveying the heads of medical research institutes and other health organisations for their views, as well as those individuals known to have an interest in such issues. We will keep updating this post so stay tuned...And please let us know what you think.

Response from Dr John Dowden, Editor, Australian Prescriber

1. Should doctors and other health professionals and professional organisations participate in advertorials sponsored by companies that are promoting products or raising awareness about diseases etc?

Advertising: ideally, no. Raising awareness: possibly.

2. If not, why not?

People generally trust health professionals, so a statement from a health professional may be readily accepted by other professionals and the public. That trust will be undermined if the professional is being paid for their comments.

3. Are there any circumstances where you would support it?

It is easier to support messages about prevention, but there can still be potential conflicts of interest if the organisation or individual giving the message will benefit from providing the service.

4. Any other issues you’d like to raise?

Clinicians who have conducted drug trials become very knowledgeable about the products used in the trials. They are important resources of information and can be expected to share their results. However, there is a risk of becoming an advocate for a particular product. Many stories of ‘breakthroughs’ seem to have an expert attached. I don’t think all of these experts realise that they have become part of a marketing campaign.

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Response from Dr Stacy Carter, Senior Lecturer, Centre for Values, Ethics & the Law in Medicine and the School of Public Health, University of Sydney

1. Should doctors and other health professionals and professional organisations participate in advertorials sponsored by companies that are promoting products or raising awareness about diseases etc?

No

2. If not, why not?

Because it changes the incentive structure and professional identity of health professions. Corporate priorities and health professionals’ priorities should be very different. Corporations must put their shareholders first. Health professionals should put individual consumers’ (their patients’) interests first. (Of course this is an over-simplification, and of course health professionals have plenty of other competing interests, but that doesn’t diminish the very real difference). Spruiking a company or product to anyone who will listen for cash is the opposite of providing thoughtful, tailored advice in an individual patient’s best interest. Thus a doctor in an advertorial undermines not only their own trustworthiness but by implication that of their whole profession.

3. Are there any circumstances where you would support it?

No – let corporations do their own advertising.

4. Any other issues you’d like to raise?

I think the same principle applies for consumer organisations.

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Response from Jon Wardle, School of Population Health, University of Queensland

1. Should doctors and other health professionals and professional organisations participate in advertorials sponsored by companies that are promoting products or raising awareness about diseases etc?

In instances in which they are remunerated specifically for this purpose I think that no, they should not be allowed to market specific products – even under the guise of disease awareness. This view may represent my admittedly Goughish leanings but I believe that professional involvement in company sponsorship which obviously points to specific products and excludes other options in health should only be allowed without monetary incentive. Any relationship needs to made obvious.

2. If not, why not?

There is a very real and obvious conflict of interest in selling the goodwill of these institutions and persons and any financial relationship should be disclosed in detail and made publicly accessible. In many circumstances the public has invested substantially in these groups and individuals and they share an obligation to promote the public interest.

3. Are there any circumstances where you would support it?

There may be some circumstances where it could be supported – for example a generic drug being promoted for free by individuals with no financial gain (I am thinking here of something like HIV therapy). However I feel that this should be the practitioner’s choice. If they feel passionately about the therapy they should not have to be paid to advertise it. I’m certain that this would reduce the number of people willing to put their hands up. Otherwise a disclaimer of conflict of interest – possibly similar to that seen in medical journals but with more specific details – could appear prominently in the piece. However, under no circumstances should a specific product be suggested to be superior over similar products unless supported by research.

4. Any other issues you’d like to raise?

I notice you’ve included complementary medicines in your register of influence – as you are aware this is my main area of interest. You may be interested to know that a separate category of CAM exists called ‘practitioner only products’. According to the TGA this is meant to be a professional range not accessible to the lay public but in reality it offers a loophole excludes these products from labelling laws (as they are not meant ‘for the public’ though I find they are quite easily accessible) and allow for unsubstantiated health claims to be made (again, as they are marketed towards health professionals they are thought to have the wherewithal to critically approach this information). I have found that the supplement/pharmaceutical companies are abusing this loophole to encourage off-label, adventurous or plain unproven and unlikely prescribing for their products. Given the fact that the majority of CAM CPE (about 90%) is run by these companies and that practitioners (not just CAM but pharmacists and doctors) are allowed to sell this product at the site of prescription (with recommended practitioner mark-ups of between 50-75% – as far as I am aware the only other industry that has profit margins this high is liquor in a restaurant setting) I feel that this is a massive oversight on the part of regulators. I’ve not looked into the advertising in professional CAM journals in depth but I can say that from the cursory experience I’ve had with reading them I find much of it to be often more dubious than public advertising.

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