The efficiency of self-regulation in pharmaceutical marketing in the UK is coming under scrutiny due to delays in processing complaints against pharmaceutical companies. Is this a result of ineffective self-policing?
The processing of complaints about the marketing practices of pharmaceutical companies in the United Kingdom has been increasingly delayed in recent years, as reported by the British Medical Journal (BMJ) in a peer-review published in February of this year. According to a BMJ investigation, processing times for complaints against pharmaceutical companies, suspected of violating the code of conduct of the UK industry for the promotion of medicines, have more than tripled over the last nearly two decades. This has resulted in problematic practices listed in complaints persisting for an average of eight months – in many cases, even longer than a year.
In response to this backlog, the Association of the British Pharmaceutical Industry (ABPI) has raised the fees levied on companies for such grievances by over 40 %. The ABPI is the trade association founded in 1891 representing over 120 companies in the UK manufacturing prescription medicines for humans. Member companies research, develop, produce, and supply medicines prescribed by the National Health Service. The ABPI Code of Practice also sets out the requirements the industry must meet and “supports companies’ commitment to self-regulation and professional, ethical, and transparent conduct”.
The processing of complaints against ABPI members and non-members who have ratified this ABPI code of conduct is handled by an independent body, the Prescription Medicines Code of Practice Authority (PMCPA). In serious cases, the ABPI can also suspend members. For example, the Danish pharmaceutical giant Novo Nordisk is currently suspended by the ABPI until 2025 for sponsoring weight loss programs that advertise its products. Experts have publicly praised the pharmaceutical manufacturer's weight loss injection Wegovy® in the past without disclosing their financial ties to the company. Novo Nordisk paid millions to experts and organizations to influence the debate on obesity and promote the use of Wegovy® in the NHS. The transparency of financial relationships and the independence of experts have been called into question and the current global supply shortages may possibly be the result of this advertising campaign, as speculated in many quarters.
Complaints have been successfully lodged with the ABPI on this matter. However, their work is less effective if it takes too much time to process complaints. BMJ’s analysis of PMCPA data shows that the average processing time for a complaint between 2004 and 2021 has more than tripled. As a result, the time taken to process an average complaint has increased from less than three months (11.8 weeks) to over 8.5 months (38.4 weeks).
In cases where appeals have been made, the duration has more than doubled over the same period, from less than five months (20.4 weeks) to over 10 months (43.3 weeks). The resolution of numerous complaints has taken more than a year.
What do the experts say? Susan Bewley, former chair of the charity HealthSense-UK, expressed concern about the delays and emphasized the importance of efficient complaint processing. Alex Fell, Director of the PMCPA, commented on the organization’s priority to improve processing times and invited BMJ readers to participate in an ongoing public consultation on proposed changes to the ABPI Code and Constitution.
The ABPI is now attempting to influence these processing times through financial means. In January, the ABPI increased the administrative fees for companies found to have breached their code of conduct from £3,500 to £5,000. Pharmaceutical companies that unsuccessfully complain about the practices of other companies will face the same fee. The ABPI has also raised the annual levy charged to its member companies. The ABPI stated that increasing the fees would partially help reduce long processing times. Amit Aggarwal, Executive Director of Medical Affairs at the ABPI, emphasized the ABPI Board’s support for the PMCPA to ensure resources are provided to address the backlog.
The question of the effectiveness of the self-regulation system has also been raised. Critics have expressed doubts about whether the sanctions imposed under the current system are sufficient to improve compliance with regulations.
Image Source: Christopher Luther, Unsplash
