51app

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Editorials

Captured by design: the drug industry and UK healthcare

51app 2024; 384 doi: (Published 19 February 2024) Cite this as: 51app 2024;384:q408
  1. Margaret McCartney, senior lecturer1,
  2. Frank Sullivan, professor of primary care medicine1,
  3. Kamran Abbasi, editor in chief2
  1. 1St Andrews University, St Andrews, UK
  2. 2The 51app, London, UK
  1. Correspondence to: M McCartney mm494{at}st-andrews.ac.uk

A broken system must be fixed in the public interest

The UK drug industry has much to be proud of, but the interests of industry, patients, and a cost effective NHS are not always aligned—and may be fundamentally opposed. Almost 20 years ago, the UK parliamentary health select committee’s report on The Influence of the Pharmaceutical Industry was damning.1 “The regulatory system, the medical profession and government,” concluded the committee, “have all failed to ensure that industry’s activities are more clearly allied to the interests of patients and the NHS.”

Instead of triggering an improvement, the past two decades deliberately delivered less caution and more industry involvement. Industry’s interests are increasingly favoured over evidence based decision making, risking sustainable and safe patient care and making healthcare costs hard to control. The landmark health select committee verdict is banished from memory amid the propaganda of drug innovation, accelerating access to new medicines, and “taking back control” with Brexit.

Robust regulation matters because the benefits of new drugs are often overstated early on, and as more data emerge, the upside tends to become less clear and harms more apparent. The recent example of anti-amyloid medications for Alzheimer’s disease is a good illustration of overstated benefits, understated harms, weak regulation, and industry influence.2 Our understanding of these dynamics dates back over a quarter of a century.34

Organisations such as …

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