Information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing: a systematic review.

Background: Pharmaceutical companies spent $57.5 billion on pharmaceutical promotion in the United States in 2004. The industry claims that promotion provides scientific and educational information to physicians.

Do advertisements for antihypertensive drugs in Australia promote quality prescribing? A cross-sectional study.

Background: Antihypertensive medications are widely prescribed by doctors and heavily promoted by the pharmaceutical industry. Despite strong evidence of the effectiveness and cost-effectiveness of thiazide diuretics, trends in both promotion and prescription of antihypertensive drugs favour newer, less cost-effective agents. Observational evidence shows correlations between exposure to pharmaceutical promotion and less ideal prescribing.

Do advertisements in clinical software influence prescribing?

Pharmaceutical companies must believe there are benefits from advertising, but just what these benefits are, and how they are measured, is not clear.

Is Australia's national medicines policy failing? The case of COX-2 inhibitors.

Australia has a National Medicines Policy with aims that include quality use of medicines, but policy stakeholders failed to protect Australia from the COX-2 (cyclo-oxygenase-2) inhibitor disaster. Drug regulators did not warn prescribers appropriately about potential cardiovascular risks. The Pharmaceutical Benefits Scheme did not limit unjustified drug expenditures on COX-2 inhibitors.

Educating health professionals about drug and device promotion: advocates' recommendations.

Mansfield and colleagues outline the recommendations from four advocacy groups for improving the education of health professionals on promotion of drugs and devices.

What are the public health effects of direct-to-consumer drug advertising?

Only two industrialized countries, the United States and New Zealand, allow direct-to-consumer advertising (DTCA) of prescription medicines, although New Zealand is planning a ban. The challenge for these governments is ensuring that DTCA is more beneficial than harmful. Proponents of DTCA argue that it helps to inform the public about available treatments and stimulates appropriate use of drugs for high-priority illnesses (such as statin use in people with ischemic heart disease).

Banning all drug promotion is the best option pending major reforms.

Drug promotion should be evaluated according to its impact on health, access to information, informed consent, and wealth. Drug promotion currently does more harm than good to each of these objectives because it is usually misleading. This is a systemic problem.

Management of hyperlipidaemia.

Background: Hyperlipidaemia is a general term for elevated concentrations of any or all lipids in the plasma. An elevated cholesterol is one of several risk factors for coronary heart disease (CHD). In Australia, the use of cholesterol lowering drugs, mainly statins, consumes over 880 million dollars or 16% of the Pharmaceutical Benefits Scheme drug budget and is growing.

The ethics of pharmaceutical industry relationships with medical students.

Little research has been done on the extent of the relationship between the pharmaceutical industry and medical students, and the effect on students of receiving gifts. Potential harms to patients are documented elsewhere; we focus on potential harms to students. Students who receive gifts may believe that they are receiving something for nothing, contributing to a sense of entitlement that is not in the best interests of their moral development as doctors.

Efficacy and safety of antidepressants for children and adolescents.

How safe and effective are antidepressants in children and adolescents? The authors of this review have found disturbing shortcomings in the methods and reporting of trials of newer antidepressants in this patient group

Escitalopram: superior to citalopram or a chiral chimera?

Background: Escitalopram is the active isomer of the antidepressant citalopram. In theory single-isomer drugs may be superior but few have been found to have clinically significant advantages. The manufacturer claims that escitalopram has more efficacy and a faster onset of effect than citalopram.

Healthy Skepticism's new AdWatch: understanding drug promotion.

The AdWatch section of the Healthy Skepticism website (http://www.healthyskepticism.org/adwatch.