Psychiatry and the pharmaceutical industry

We read with interest the editorial ‘Dancing with the Devil? A personal view of psychiatry’s relationship with the pharmaceutical industry’ (Psychiatric Bulletin, March 2005, 29, 81-83) as we feel it has much relevance for developing countries such as Sri Lanka. It appears that the pharmaceutical industry employs different methods when dealing with developing countries; these include the provision of poor details of products which sometimes lead to deleterious effects.

The pharmaceutical industry and the medical profession mainly interact through the sales promotion of drugs and symposia organised by pharmaceutical companies. The industry influences prescribing patterns through drug promotion but, if interactions between doctors and drug companies are transparent, no impropriety will be alleged (Breen, 2004).

Large scale commercial trials are still not conducted in Sri Lanka although help is often given informally (either money or equipment). However this may change as more companies look towards developing countries to carry out clinical trials because of the low cost and availability of human resources.

Research funded by pharmaceutical companies is less likely to be published and is more likely to have an outcome favourable to the sponsor (Lexchin et al, 2003). Nevertheless, the interaction between academia and the pharmaceutical industry is valuable but should be regulated by academic departments (Montaner et al, 2001).

In many developing countries clinicians rely on drug treatment more than in the west due to a shortage of human resources for time-consuming psychological therapies. However, although psychiatrists in developing countries may be more vulnerable to undue influence by pharmaceutical companies, we believe that the governing ethical principle that our primary obligation is to the patient will guide us to be independent and help us follow rational prescribing practices.