July 2002

Dear Readers: Here's the Article for this Month:

Name of article:

USE OF TRADE NAMES OF DRUGS AND THE SCIENTIFIC CONTENT OF MEDICAL CONGRESSES

  Ripamonti C, Sweeney C, Bruera E.

Author(s):
J Clinical Oncology   Vol 20, Issue 6 (March), 2002: 1707-8    Letter to the Editor (Special Departments)

Reference:
Please refer to the original study of   Bruera E, Ripamonti C, Beattie-Palmer L. Use of Trade  Names of Drugs in Abstracts from Pain Congresses . New Engl J Med 2000; September 14  page 818

Abstract:
Many studies have been carried out with the aim of evaluating the possible interactions between the pharmaceutical companies and physicians in regard to the sponsorization of research, continuing medical education, distribution of gifts, promotion material and if these interections influenced the prescriptions, attitudes and behaviour of the physicians.

This letter to the Editor of J Clinical Oncology is the discussion of the original  letter previously published in New Engl J  Med, on the use of trade names of opioid analgesics in the Abstracts from or presentations at scientific meetings as a way of promoting a drug.

The World Pain Congress, organized every 3 years by the IASP (International Association for the Study of Pain) is the most important specialistic forum for the dissemination of knowledge about the pathophysiology and treatment of pain. During the last Congress held in Vienna in 1999, we were very impressed by the evident recurrent  use of trade names of the opioid analgesics in the different poster and slide presentations as well as in the Abstract Book of the Congress.

Thus we reviewed the abstracts reporting data on opioids of the Congresses that occured in 1993, 1996, and 1999 to evaluate the frequency of the use of trade names according to the type of affiliations of the authors: pharmaceutical industry alone, pharmaceutical industry plus other institutions (private or academic medical centers), or institutions alone.

The proportion of the abstracts reporting the trade names  of the opioids showed a significant increase from 19% in 1993 to 36% in 1999 with an overall increase of 89% (p=0.007). Trade names were more frequently used in the abstract sponsored by the pharmaceutical industry alone (64%) and less frequently used (15%) when the authors did not have any industry affiliation (p<0.001).

Trade names were used in 58% of the abstracts reporting studies on the more expensive controlled release (CR) opioids (oxycodone CR, morphine CR, hydromorphone CR, and transdermal fentanyl) in respect to 10% of abstracts reporting studies on immediate release (IR) opioids  (p<0.001).

Trade names were used (mean +/- SD) 4.6 +/- 4.2 times in the abstracts on CR opioids compared to 2.2 +/- 2.3 times in the abstracts on other opioids (p<0.001).

It was possible to identify an industry affiliation in 53% of abstracts on CR opioids, compared with 18% of abstracts on other opioids (p<0.001).

These data show that the use of trade names is not an exception in abstracts reporting on the more expensive patented opioid drugs, such as CR opioids, and where there is the pharmaceutical industry participation.

Data of literature on pharmaceutical-sponsored research or meta-analyses carried out in patients with rheumatic disease or stroke, show results favorable to the sponsor’s treatment differently from those obtained by researchers with no industry affiliation.

The authors of this letter ask themselves and the readers the following questions:

1.      Why the trade names are more frequently mentioned by the pharmaceutical companies and why this use is also significantly related to the more expensive patented opioid drugs.

2.      Is it essential, from scientific and educational perspectives, to use the trade names?

3.      Is it ethical to use the trade names if it is not essential?

4.      Why do the academic physicians who participate in this research agree to the use of trade names?

According  to our opinion the use of trade names in the contexts above mentioned has initiated a slippery slope by the pharmaceutical companies consisting of publishing new results or even recycled data regarding expensive opioids with the aim of focusing  the attention and thus influencing the prescription through the promotion rather than a wide-spread diffusion of scientific knowledge.

In controlled clinical trials comparing the efficacy and tolerability between CR and IR opioids, there have been no significant differences between the two formulation types.

The duty of maintaining ‘ethical  standards’ in scientific journals, congresses, continuing medical educational programs, does not involve ultimately the pharmaceutical indistry but rather the organizers of congresses, the leadership of scientific organizations, the invited speakers, the authors of the abstracts and papers and finally the participants and the readers who should put raise the point regarding the use of unnecessary publicity.

We believe that ethical medical congresses can be defined those in which the scientific content has the aim of helping and benefiting the patients we care for.

Why I chose this Article:

This letter to the Editor has the aim of bringing the scientific community’s attention to the necessity of maintaining ethics in information through national and international journals, scientific meetings  and congresses, training schools and up-dating courses, continuing medical educational  programs, slide presentations  even if, and above all, when they are sponsorised by the pharmaceutical industry.

Regards,

Carla Ripamonti, MD
Member of the Board of Directors, IAHPC