The Drug industry

In veterinary practise, ten to thirty percent of general running costs are incurred through use of pharmaceuticals. From aspirin to zithromycin, we dispense vast quantities of drugs to treat animals and keep them healthy. To do this, we need wholesale suppliers of drugs, who ship by the boxful our urgently needed provisions. Without pharmaceuticals, it would be nigh impossible to treat a sick animal. We could still diagnose and give advice, but most treatments require some form of drug. There can be no surgery without anaesthetics. No palliative care without anti-inflammatories. A relationship with drug companies and wholesalers is vital to a successful practise. It is for this reason that we listen to drug representatives who inform us of the latest drug release, of conferences they are supporting, to promote their latest product. We go, hoping to learn more about not only new drugs, but new treatment regimens. 

Let us turn for a moment to the medical pharmaceutical industry, the big brother to the veterinary pharmaceutical industry.  In human society worldwide, what determines medical health is intimately related to a number of social factors;

Ø         economic status

Ø         education

Ø         physical living conditions

Ø         culture and history

Ø         issues of gender and human rights

Ø         level of peace and safety.

Our race and religion, and how wealthy and educated we are determines where we live and vice versa. Where we live directly influences the access to medical treatment. This is not an entirely new concept. There is no level playing field in human medicine.  Even in the USA, supposedly a land of freedom, liberty and equality, access to medicine is still largely determined by income. The pharmaceutical industry, which has recognised this connection between living conditions and health status since the early 19th century, is one of the largest and most profitable industries in the world[i]. Because of its vast resources, the pharmaceutical industry has garnished increasing influence on the medical and veterinary markets, which, given the differences in values and priorities between professionals and the drug companies, is a cause for concern. The pharmaceutical industry has acted to maximise its profits in ways that frequently conflict with medicine’s need for truth and full disclosure. Indeed, the industry has arguably worked to compromise clinician’s judgments as well as academic standards[ii].

For a pharmaceutical manufacturer to remain in business, it is crucial for them to develop a sensitive antenna for the needs of the public. Pharmaceutical marketing mirrors a subtle play with dormant notions about health, illness and healing. When looked at this way, the veterinary market has the potential to become a place where drug sales are negotiated by the marketing strategies of drug companies rather than on the grounds of efficacy and clinical relevance[iii]. Because of the burgeoning influence of drug companies on medical protocols during the past decade, ethical principles have eroded the relationship between clinicians and the pharmaceutical industry[iv]. Two areas in which the decline has been most notable are gifts to clinicians and the relationships of industry to educational and research activities. The gifts have become more valuable and industry representatives make gifts available under circumstances where frequently there is no educational program.

Clinicians increasingly find themselves in positions that present conflicts of interest with the interests of patients[v]. Additionally, research which is funded directly by pharmaceutical companies has also shown to be biased, with evidence of duplicate publication, selective publication, and selective reporting[vi]^,[vii]. Academic-industry relationships have shown to create areas of conflict particularly where a financial commitment to projects can affect the welfare of animal. As well, conflicts of interest emerge in research decisions that could damage the integrity of research, especially scientists’ withholding of data and their redirecting of research in more commercial directions. These effects can also undermine public trust in and support of university researchers. The best solution at present appears to be a strict adherence to the existing ethical principles by clinicians and industry. Veterinarians must renew observance of professionalism and improve oversight and discipline. Although veterinary science cannot impose restrictions on the pharmaceutical and manufacturing industries, we can appeal to industry’s leadership. There must be an ethical common ground if clinicians and industry are to succeed in producing a climate of mutual respect and higher ethics; patients will benefit and physicians and industry will regain the public trust.