Author: Richard Smith
Position: Chief Executive
Institution: UnitedHealth Europe
E-mail: richardswsmith@yahoo.co.uk
Submitted Date: October 30, 2005
Published Date: October 30, 2005
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

The government finally produced its response to the Health Committee's report in September 2005. In the meantime, Britain had had a general election? - so a five month delay is perhaps acceptable. The Health Committee's report had a bold, almost strident tone that said: 'We've got a serious problem here. Something must be done.' The report was written to be read. In contrast, the government's response is soothing, almost hypnotic. It says: 'Things are essentially fine. Don't worry.'

The government will have been heavily lobbied by the industry. Its response is not written to be read.

The government does, however, agree that transparency is important. 'Patients rightly expect transparency in how their treatment is delivered, and the development and introduction of new medicines is no different.' The government doesn't, however, support the committee's recommendations of a clinical trials register maintained by an independent body and of requiring full information on trials to be made available on the launch of drugs. It thinks that what is already proposed is adequate. Nor does the government think that there is a need for regulatory bodies and ethics committees to become more involved in planing trials to make sure that they answer real questions.

When it comes to limits on marketing, the government simply says: 'There is no indication that the measures in place are not effective.' It does, however, intend to extend current measures: so all promotional material will now be prevetted by the regulatory authorities - not just material on new chemical entities as is currently the case.

As I predicted, the government rejected the proposal of holding a public inquiry every time a drug is withdrawn on health grounds. It does intend to review the Medicines and Healthcare Products Regulatory Agency, but all such bodies tend to be regularly reviewed anyway. Indeed, the current government is so keen on restructuring and reviewing such bodies that some find themselves abolished within days of being established.

The government 'does not accept that there is lack of independent advice to prescribers on medicines.' Nor does it accept that the Department of Health has a fundamental conflict of interest in having to promote the interests of both patients and the pharmaceutical industry.

So most of the recommendations of the Health Committee have been rejected or watered down. The status quo is the way forward - until another big scandal hits. It may be that 'The Constant Gardner', the powerful and polemical film of John le Carre's novel on the perfidiousness of the pharmaceutical industry that is just opening in Britain, will ultimately lead to more changes than the Health Committee.