Take a doctor to dinner.
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Self-regulatory codes of conduct are used to control the promotional practices of the pharmaceutical industry, but the effectiveness of these codes in controlling pharmaceutical representatives' presentations has not been examined. This is a matter of concern because pharmaceutical representatives have more influence than any other promotional media on prescribing practices. The authors developed a method for monitoring the oral presentations of pharmaceutical representatives when promoting products to medical practitioners. Sixteen audio-recordings, detailing 64 medicines, were obtained; 38 of the 64 products were prescription-only medicines. Information on indications and on dosage and administration was commonly provided, but information on other areas of drug knowledge, particularly product risk, was minimal. Thirteen presentations contained at least one inaccuracy when compared with Australian Approved Product Information. Presentations did not always comply with current guidelines in the Code of Conduct. The Code provides only limited standards for pharmaceutical representatives' presentations, and no active monitoring system is in place to ensure adherence to the code. There is an urgent need for policy development on the role of pharmaceutical representatives, their standards of practice, and regulation of their activities to ensure they contribute to the appropriate use of medicines.
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Pharmaceutical promotion in Canada is controlled by two codes: a voluntary one developed by the Pharmaceutical Advertising Advisory Board dealing mostly with printed promotional material, and one from the Pharmaceutical Manufacturers Association of Canada covering other forms of promotion. This article looks at enforcement of the provisions of these codes and at areas in which they are deficient. One of the major weaknesses in both codes is their lack of effective sanctions for companies that violate their provisions. Strong codes are necessary because many physicians rely heavily on promotional material for their source of prescribing information. However, voluntary codes or codes developed by the industry are inherently weak and lack effective enforcement mechanisms. Although the U.S. Food and Drug Administration is currently very active in curtailing promotional excesses, government control is not the solution since regulatory action will depend on the ideological position of the head of the regulatory body and/or the party in power. An independent body backed by legislative authority is preferable.
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In the early twentieth century, a time when patent medicine men were stereotyped as evil and dishonest, G. T. Fulford of Brockville, Ontario made his fortune from an iron pill called Dr. Williams' Pink Pills for Pale People. Once successful, Fulford remained in Brockville where he served on the town council and gave generously to charities. In 1900 he was appointed by Laurier to the Senate. When he died in 1905 he was remembered as a kind and ethical man. His story, like that of several other prominent patent medicine men, conforms more with the ideals of Samuel Smiles than with the popular image of disrepute.
The biological effects of cyclosporin, namely immunosuppression and absence of cytotoxicity, were discovered-in the course of a general screening program in which many scientists at Sandoz were involved. Contrary to some statements in the literature both Dr J. Borel and Dr H. Stähelin markedly contributed to the discovery and characterisation of the biological profile of the drug. In its subsequent exploitation Borel played the leading role. The outstanding clinical importance and the extraordinary commercial success of cyclosporin explain the widespread interest in the history of its discovery and development. It is also understandable that the recollection of the events by the individuals involved in the early phases of this history is influenced by subjective impressions and interpretations, which do not always reflect the historical facts. It is the purpose of this report to record and interpret the facts as accurately and as completely as possible on the basis of the available records.