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IDDT’s Position Statement on DTCA
Issued April 2002
Provision of information to consumers by pharmaceutical companies
The Insulin Dependent Diabetes Trust [IDDT] is an international patient organisation for people that live with diabetes. In order to function in the best interests of this consumer group without any conflicts of interest, we have a stated policy that we will not accept any funding from the pharmaceutical industry, unlike many other diabetes organisations.
We are totally opposed to the proposal that the pharmaceutical industry should be allowed to supply disease-related information directly to consumers and to any movement towards DTCA. While we accept that there may be a need for consumers to have more information about prescription drugs in language they can understand, we strongly believe that both this and information about the condition being treated should be as unbiased as possible. Therefore it is inappropriate that it should be provided by the pharmaceutical industry whose understandable aim, is profit.
The ability for consumers to obtain independent information is already threatened by:
- Industry funded research and conflicts of interest and prestigious research institutions receiving industry funding, so blurring the relationship between research and commercial gain.
- Preparation of clinical guidelines, an article in JAMA, February 2002, finding that 90% of the authors received funding from or acted as consultants to drug companies
- ‘Fast track’ approval of drugs coupled with ADR reporting systems being grossly underused. In diabetes, troglitazone highlighted this situation when at least 92 people died and many others were damaged because the drug was heavily marketed with a lack of independent evidence-based information.
- The many ways in which physicians or their departments and staff are sponsored by industry.
People with diabetes have already witnessed the power of drug company advertising to the medical profession. In the 1980s the majority of people requiring insulin were transferred to genetically produced ‘human’ insulin even though there was, and still is, no evidence that ‘human’ insulin has any clinical advantages for patients over the natural animal insulin. Despite a catalogue of adverse reactions to ‘human’ insulin, it is now first line treatment for insulin requiring diabetes. People are not given the choice of insulin species and if information is requested, many people are told by their physician, diabetes nurse specialist and/or their pharmacy that animal insulins are no longer available. As Novo Nordisk only advertise their more profitable synthetic ‘human’ insulins to professionals, this misinformation may be understandable. However, it has affected prescribing habits resulting in a diminution of the sales of animal insulins so enabling the manufacturers to try to justify discontinuation of animal insulins in many EU countries.
In addition, global insulin production is in the hands of three multi-national companies providing them with a dominant market position. If they are allowed to provide information direct to consumers, the few remaining small insulin manufacturers will be unable to compete, resulting in ‘blockbuster human’ insulins that are not tolerated by a significant minority of people with diabetes.