who medicines strategy - libdoc.who.int - World Health Organization
who medicines strategy - libdoc.who.int - World Health Organization who medicines strategy - libdoc.who.int - World Health Organization
WHO MEDICINES STRATEGY 2004-2007 | 120EO 7.4Responsible ethical medicinespromotion for health professionalsand consumers encouragedRationaleThe rational use of medicines has often beenundermined by the unethical marketing ofmedicinal products through advertising or theactivities of medical representatives. The Reportby WHO’s Director-General to the 49th WorldHealth Assembly highlights the continued“imbalance between commercially produceddrug information and independent, comparative,scientifically validated and up-to-date informationon drugs for prescribers, dispensers, andconsumers.”Drug companies spend large amounts of moneyon promoting their products to doctors aroundthe world. In the United States, the industryspent over US$13.2 billion in 2000, whileUS$1.1 billion was spent in Italy in 1998. In thedeveloping world, promotion accounts for 20%-30% of sales revenue. There are currently over80 000 sales representatives in the United States,where the industry sponsored some 314 000physician events in 2005. Meanwhile, growth inspending on direct-to-consumer advertising ofprescription drugs, which is allowed in the UnitedStates, has been dramatic, with nearly US$ 2.4billion being spent in 2001. 62ProgressWHO and HAI/Europe have coordinated a projectto establish a database on promotional activities(http://www.drugpromo.info). It is hosted andadministered by the WHO Collaborating Centrefor Drug Information at the Science University ofMalaysia. The objectives of the project are to:> document inappropriate medicines promotionboth in developing and developed countries.> document the impact of inappropriatemedicines promotion on health.> provide information about tools that canbe used to teach health professionals aboutmedicines promotion.> promote networking among groups andindividuals concerned about medicinespromotion by providing links through thewebsite.As part of the project, four reviews have beenwritten to provide an overview of key promotionrelatedissues including:> What attitudes do people (professional andlay) have towards promotion?> What impact does pharmaceutical promotionhave on attitudes and knowledge?> What impact does pharmaceutical promotionhave on behaviour?> What interventions have been tried to counterpromotional activities, and with what results?
COMPONENTS OF THE STRATEGY | 121Challenges remainingWhile these reviews clearly document thelarge amounts spent on promotion, there islittle evidence on effective ways of addressingthis problem in different country settings. Thechallenge for WHO is to determine what canand should be done to ensure responsible ethicalmedicines promotion.Meeting the challenges 2004-2007Over the next four years WHO will:> continue to promote criteria for medicinespromotion 63 and provide technical supportto countries in monitoring and regulating thepromotion of medicinal products.> undertake further research to evaluate theimpact of interventions aimed at: improvingthe preparation of doctors and pharmaciststo deal with promotional challenges;how guidelines affect gifts being used aspromotional inducements; and how theenforcement of Conflict of Interest guidelinesaffect promotional activities.> review and update where necessary WHO’s1988 guidelines on ethical criteria formedicines promotion to take account ofdevelopments in communication such as theInternet and direct-to-consumer advertising.OUTCOME INDICATORS1999 2003 2007No. of countries with basic system for regulatingpharmaceutical promotion#REPORTING % TARGET#REPORTING % TARGET92/132 70% 80% 83/113 73% 76%
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COMPONENTS OF THE STRATEGY | 121Challenges remainingWhile these reviews clearly document thelarge amounts spent on promotion, there islittle evidence on effective ways of addressingthis problem in different country settings. Thechallenge for WHO is to determine what canand should be done to ensure responsible ethical<strong>medicines</strong> promotion.Meeting the challenges 2004-2007Over the next four years WHO will:> continue to promote criteria for <strong>medicines</strong>promotion 63 and provide technical supportto countries in monitoring and regulating thepromotion of medicinal products.> undertake further research to evaluate theimpact of <strong>int</strong>erventions aimed at: improvingthe preparation of doctors and pharmaciststo deal with promotional challenges;how guidelines affect gifts being used aspromotional inducements; and how theenforcement of Conflict of Interest guidelinesaffect promotional activities.> review and update where necessary WHO’s1988 guidelines on ethical criteria for<strong>medicines</strong> promotion to take account ofdevelopments in communication such as theInternet and direct-to-consumer advertising.OUTCOME INDICATORS1999 2003 2007No. of countries with basic system for regulatingpharmaceutical promotion#REPORTING % TARGET#REPORTING % TARGET92/132 70% 80% 83/113 73% 76%
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