- Medicine Information and Evidence for Policy > Information and Publications
- Medicine Access and Rational Use > Rational Use
(2005; 165 pages)
3.3 What makes an ‘independent’ drug bulletin independent?
An independent bulletin’s focus on practical comparative information about medicines is one aspect of what defines it. An essential aspect is its financial and editorial independence from pharmaceutical companies and from pharmaceutical industry associations. This independence is a fundamental basis for the work of drug bulletins, whether they focus mainly on providing comparative treatment advice for a specific health condition, assessing the benefits and harms of a new medicine, or discussing national drug and regulatory policies. ISDB defines independence as consisting of two main components1:
• being run by an independent editorial team, working within an organizational structure capable of guaranteeing editorial independence;
• financial resources that guarantee independence, such as public financing through a national or local government, financing by a non-governmental organization, or self-financing through reader subscriptions or membership fees.
Most bulletins are funded either by the organization that publishes them or by subscribers. Readers may pay individually (e.g. la revue Prescrire, France; Drugs Bulletin, India; Pharma Kritik, Switzerland). Bulletins that are published or supported by a government are generally distributed to readers free of charge (e.g. Cito!, Latvia), as are some bulletins published by non-governmental organizations (e.g. Boletin AIS-COIME, Nicaragua).
Drug bulletins do not rely on pharmaceutical advertising, unlike most medical journals. Journals that carry advertising from drug companies are vulnerable to conflicts of interest and often cannot publish openly critical comments when this would be in the interest of patients and prescribers.
Drug bulletins differ in many ways. These include:
• who reads them: is it doctors, pharmacists, rural health workers, the public?
• the main focus of their articles: is it drug policy, adverse effects, new drugs, treatment guidelines?
• the size and presentation of the bulletin, from a two-sided single sheet to an 80-page magazine; from simple black on white printing to glossy paper and full colour illustrations;
• the size of the editorial team and staff;
• how much they rely on unpaid volunteers;
• their institutional base and organizational structure;
• funding sources.
Case study: Boletin AIS-COIME, Nicaragua
Boletin AIS-COIME is produced by AIS-Nicaragua, a national NGO, which promotes the appropriate use of drugs through information, training, research, networking and advocacy. The 12 - 16-page bulletin is distributed free of charge to all doctors working in hospitals and primary health care units of the Ministry of Health, to pharmacy and medical students and teachers, NGOs and some private pharmacies.
AIS-COIME focuses on rational use of standard drugs and on treatment guidelines. But it also includes articles about drug policy, information about some relevant new drugs introduced to the national market, adverse drug reactions, critical appraisal of advertising and results of monitoring of the WHO Ethical Criteria for Medicinal Drug Promotion, and tests of knowledge about topics published in previous bulletins.
The bulletin is produced by a small editorial team of three or four people and a group of volunteers who revise the articles. The bulletin has been financed mainly by international NGOs and some of the issues by the Pan American Health Organization (PAHO). One of the objectives of the bulletin is to be useful as a support for continuing education activities in the primary health care unit of the Ministry of Health. La revue Prescrire and WHO Essential Drugs Monitor have been important references.
Contributed by Benoit Marchand, Boletin AIS-COIME, Nicaragua.