Volume 192 - Issue 5
Winds of change: growing demands for transparency in the relationship between doctors and the pharmaceutical industry
Authors: Iain S Pratt, Clare L Hughes and Terry J Slevin
Med J Aust 2010; 192 (5): 293-295. || doi: 10.5694/j.1326-5377.2010.tb03518.x
Published online: 1 March 2010
Published online: 1 March 2010
To the Editor: There is no doubt that the relationship between doctors and the pharmaceutical industry, described by Mitchell,1 is a complex one. Mitchell states that: “There are few, if any, analogies for the relationship between the medical profession and the pharmaceutical industry”.1 We contend that, as medical professionals are to the pharmaceutical industry, nutritional health professionals are to the food industry.
Nutritional health professionals, like medical professionals, span the health care spectrum — from research and public health to tertiary care — and include doctors, dietitians, nutritionists and nurses.
The food industry is more expansive than the pharmaceutical industry, encompassing primary producers, manufacturers, retailers and parts of the pharmaceutical industry. Some definitions include alcohol as part of the food industry. As well as this difference in magnitude, there are other substantial differences between the pharmaceutical and food industries.
Contact between the food industry and health professionals is ubiquitous and unavoidable, but lacks the oversight provided by the, albeit voluntary, Medicines Australia code of conduct.2 It is unrealistic to suggest that health professionals should be completely divorced from the food industry. The alcohol industry is, however, the exception.3 Appropriate engagement between health professionals and the food industry has the potential to improve population health.4 Product reformulation (to improve the nutrient profile, such as reducing salt or fat content) and repackaging (to make smaller portions) are examples of successful partnerships between health professionals and the food industry.
The food industry must work with health professionals to respond to consumer demand for healthier foods. Yet many of these foods are still of questionable nutritional quality, or of benefit only in very specific cases. Medications, on the other hand, must be proven before they enter the market.
Finally, the food industry is able to advertise directly to the public and use health professionals to promote their products. This creates opportunities for endorsement — perceived or otherwise — of specific foods or brands by key opinion leaders, like doctors or sporting icons, who have varying degrees of nutritional expertise but are nevertheless viewed by the public as credible.
Increasing rates of obesity legitimately prompt greater scrutiny of food industry activity.
Analogous to the relationship between the pharmaceutical industry and doctors, it is equally necessary to “. . . expeditiously formalise a relationship of integrity and transparency . . .” between health professionals and the food industry.1 A code of conduct, equivalent to that of Medicines Australia, may be a necessary next step.
References
- Mitchell PB. Winds of change: growing demands for transparency in the relationship between doctors and the pharmaceutical industry. Med J Aust 2009; 191: 273-275. 0_CBBIHDDJ
- Medicines Australia. Code of conduct. Edition 15. 2006. http://www.medicinesaustralia.com.au/pages/page254.asp (accessed Sep 2009).
- Miller PG, Kypri K, Chikritzhs TN, et al. Health experts reject industry-backed funding for alcohol research [letter]. Med J Aust 2009; 190: 713-714. 0_pgfId-2003295
- Yach D. Food companies and nutrition for better health. Public Health Nutr 2008; 11: 109-111. 0_pgfId-2003306