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EDITOR'S CHOICE: Fiona Godlee Ethics at the BMJ BMJ 2007; 334: 0 [Full text]

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Dancing with the porcupines, revisited

Piero Baglioni   (24 February 2007)

Dancing with the porcupines, revisited 24 February 2007
Piero Baglioni, Consultant Physician Prince Charles Hospital Merthyr Tydfil, Mid Glamorgan CF47 9DT Send response to journal: Re: Dancing with the porcupines, revisited	Some years ago the BMJ claimed on its front cover that it was "time to untangle doctors from pharmaceutical companies" [BMJ 31 May 2003]. With this in mind, it is both puzzling and disturbing to see the prominence the journal is devoting, week after week, to paid advertising from pharmaceutical companies, in terms both of volume [over 30% of the total number of pages in this week issue] and prominence [neither the New Engl J Med nor the Lancet -for instance- allow advertising to be interspersed with the scientific material]. While the science on which these ads is based is often poor [Wilkes MS, Doblin BH et al - Pharmaceutical advertisements in leading medical journals : Experts' assessments - Ann Intern Med 1992 vol. 16 : 912-919], it provides million of pounds in revenues for the journal [Lexchin J, Light DW - Commercial influence and the content of medical journals - BMJ 2006 vol. 332 : 1444-1447]and this probably overcomes the fact that it tends to increase prescription of targeted drugs in a dose-related manner [Fugh-Berman A,Alladin K et al - Advertising in medical journals : should current practice change ? PLoS Medicine 2006 vol. 3 (e130): 0762-0768]. This is morally disputable and socially irresponsible because while most of the drugs advertised are rarely innovative [New drugs from old - Drugs & Ther Bull, Oct 2006 : 73-77], they are major contributors to the escalating cost of providing fair and equitable health care for all [Morgan SG, Bassett KL et al - "Breakthrough" drugs and growth in expenditure on prescription drugs in Canada - BMJ 2005 vol. 331 : 815-816]. Publishing may be expensive, but it is sad to see that the Editorial department cannot have more say on advertising decisions affecting the journal. Competing interests: None declared