More links to drug companies
by Peter Mac The Federal Pharmaceutical Benefits Advisory Committee (PBAC), which advises the Federal government on which drugs should be subsidised by the government for the benefit of consumers, is again under the spot light. Last year the serious work of the Committee was seriously disrupted when the Howard Government forced through a radical restructuring of its membership. This involved the effective sacking of 10 out of 12 of its members, and the installation of new members, at least one of whom had strong connections to the pharmaceutical industry, for which he had acted as a lobbyist for many years. The new controversy concerns committee members with financial interests in Pharmaceutical companies. The issue recently caused a split in the ranks of the newly-formed committee, which was equally divided as to whether members should be allowed to continue as shareholders. The committee recommended that the Chairman should seek the advice of the Minister for Health Dr Wooldrige. However, the Minister's own role has been marred by controversy over a number of "conflict of interest" issues, including the PBAC restructuring and the possible benefit to a large number of radiologists in the purchase of new diagnostic machines prior to the introduction of new government regulations. In the event, the new Chairman of the PBAC, Professor Lloyd Samson, decided not to seek the Minister's advice, and simply made a unilateral ruling that members of the committee must divest themselves of any direct shareholdings in drug companies. The ruling is still subject to endorsement by the committee as a whole, and the issue is scheduled to be discussed at a committee meeting this week. Faced with the Chairman's clear ruling, the Minister expressed some misgivings about members owning drug company shares. He did not, however, rule it out as a matter of principle, commenting somewhat equivocally that he thought it would be "unwise" to hold such shares, "even if one did disclose it". The ruling was effectively endorsed recently by another drug advisory body, the Australian Drug Evaluation Committee (ADEC), which assesses the suitability of drugs to be available for treatment of the general public. The ADEC Chairman stated last week that "For Government committees like the ADEC, financial interests like shares should exclude people from serving". However, the rules of neither the ADEC nor the PBAC exclude members from enjoying some personal benefits from drug companies, such as payment for travel, research or consultancies, and such payments do not have to be declared. The decisions of these committees have important ramifications, not only for the health of people, but for the profitability of drugs being promoted by the big pharmaceutical companies. These corporations, amongst the most profitable in the world, exert considerable pressure on governments and bodies such as the PBAC. It is imperative that such decision-making bodies are completely independent of the pharmaceutical industry. This is becoming more difficult because of the power of these corporations and the growing links between the public and private sectors. These days, research projects are frequently funded on a joint basis by governments, medical personnel and/or drug companies, with the potential to ensnare medical practitioners and researchers in ethical dilemmas. A research project headed by a former member of the PBAC, Dr David Henry (one of those who most vigorously fought Dr Wooldridge's restructuring of the committee) was recently revealed to have received part of its funding from a drug company. It seems clear, however, that Dr Henry did not benefit in any direct personal way from this arrangement, nor was the outcome of his research in any way influenced by it. On the other hand it is by no means clear that the same can said for all the new members of the PBAC, at least one of whom has indicated that he will be considering his position on the Committee if it adopts the Chairman's ruling on shareholdings.