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To the Editor: The guidelines proposed by Dr Brennan and colleagues¹ to mitigate the influence of pharmaceutical company marketing strategies on physician prescribing habits in the United States provide a long overdue template to inform policy formulation by drug regulatory bodies elsewhere in the developed world. However, in concentrating on the relationship between pharmaceutical companies and AMCs, these guidelines divert attention from general practitioner vulnerability to being influenced by pharmaceutical company incentives.

In Australia, federal government expenditure on nonhospital prescriptions for the fiscal year ending June 30, 2005, totaled US $3848 million, with a trend toward the prescription of newer, more expensive drugs that are not necessarily more effective.² This threatens the sustainability of the Pharmaceutical Benefits Scheme that governs government subsidy of prescriptions, which has grown by 8% to 12% per year between 1993 and 2004.³ A significant proportion of nonhospital prescriptions are generated by general practitioners.³

The setting . . . [Full Text of this Article]

Joseph Yuk Sang Ting, MBBS, BMedSci, FACEM
joseph.ting@mater.org.au
Department of Emergency Medicine
Mater Public Adult Hospital
South Brisbane, Queensland, Australia

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