In reply: It is encouraging that Donohoo, on behalf of MIMS, supports initiatives to more regularly update product information (PI). My review1 demonstrates that necessity. The material published by MIMS is apparently not under their direct editorial control; it depends on PI from the pharmaceutical industry, vetted by the Therapeutic Goods Administration. Revision of PI by drug sponsors has major inertia.2

While the problems in the thyroid area can be serious for a fraction, perhaps 1%–2% per year, of the 200 000 people who take thyroid medications, I made no assertion that the deficiencies identified for thyroid-related medications reflect other PI-based information; that question remains open.

Donohoo emphasises that the PI-based information in MIMS is not a stand-alone resource for health professionals, who are able to choose between sources of drug information. By contrast, consumers are offered PI-based consumer medicine information (CMI) as a definitive resource, without choice. The obligatory link between PI and CMI3 is a compelling reason for revision of PI.

In my view, the National Prescribing Service, an organisation that publishes the journal Australian Prescriber and fosters quality use of medicines, is the national resource best placed to show initiative to improve the current deplorable state of thyroid-related PI which is, in my view, an impediment to safe, well informed health care for some thousands of Australians. Together with Donohoo, I support debate and initiative.