Professors Webb and Paterson claim the public can be protected from the risk of industry influence in drug safety assessments by expert assessors declaring an interest (Drugs panel needs 'big pharma' ties, Letters, April 6).

But the Scottish Medicines Consortium (SMC) has not lived up to its own rules.

These say "interests declared to the SMC by chairmen and members of all committees will be published each year in the Annual Report of the SMC". But it has not published an annual report since 2008. Three of the six years of non-disclosure were on Paterson's watch.

Loading article content

Webb and Paterson draw a distinction between declaration of interests "which mostly relate to research or other funding received" from the pharmaceutical industry and "personal" interests. Only the latter leads to an expert being "excluded from all discussion and decision-making on the medicine in question". But can it be right that an expert in receipt of industry research grants can contribute to judging the suitability and safety of drugs made by the same firm?

Rather than working in "partnership" with the pharmaceutical industry, would it not be better to work in partnership with the public? Yet the public currently has a minor role, structurally subordinate to the "patient" groups.

It is easy to agree with Webb and Paterson that there should be "greater clarity around the funding, membership and management" of patient groups in the drug approval process. Financial relationships between patient groups and pharma should always be disclosed and the SMC should take steps to manage such conflicts out of the system.

Industry-funded patient groups should have no role in assessing the safety or appropriateness of drugs used by the NHS in Scotland.

David Miller

Professor of Sociology

University of Bath