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March 13, 2013

The British Pharmacological Society champions its science

From Research Fortnight, 13 March 2013.

The learned society representing pharmacologists supports sound science and medicine, and works constructively at the interface of research, industry and government, writes Humphrey Rang.

Contrary to recent conjecture, the British Pharmacological Society has championed high-quality science to improve the discovery and use of drugs for treating disease.

At the BPS we value courage and passion in our membership and partners, and acknowledge the invaluable work achieved by additional voices in urging action on important issues such as clinical trial transparency. We welcome the contributions of individuals or smaller organisations such as Sense about Science, which the BPS supports with regular donations.

Righting wrongs, though, involves more than shouting from the sidelines. We value our active participation in partnerships and are proud to be a founder member of the Ethical Standards in Healthcare and Life Sciences Group, which targets increased transparency and accountability in collaborations with industry, for the benefit of patients.

Our 3,000-strong membership covers a broad spectrum: from internationally recognised research scientists and teachers of basic and clinical pharmacology, to members based in industry or regulatory and advisory bodies. It respects and values what the BPS stands for—honesty and reason are evident in our peer-reviewed journals, meetings, and educational and outreach work.

Despite some conflicting agendas, our diverse and growing membership gives the society a unique ability to bridge different groups. Even critics of the BPS cannot dispute the importance of working constructively at those groups’ interfaces.

For example, although a young group, the ESHLSG already has 19 member organisations, including many royal colleges and learned societies. Guidance on collaboration between healthcare professionals and the pharmaceutical industry was not produced by the Association of the British Pharmaceutical Industry [RF 27/2/13, p21] but was the first publication of the ESHLSG. It is already under review, with a revised edition due this year.

Expertise in drug discovery and development, where the UK has traditionally excelled, is at risk due to recent industry cutbacks. The BPS was co-organiser of a meeting of 20 learned societies, with input from industry representatives, to discuss this problem. From it emerged the Drug Discovery Pathway Group, involving the BPS, Society of Biology, Academy of Medical Sciences, Royal Society of Chemistry and Biochemical Society. This group is engaging with government, industry and academia to find ways to minimise erosion of high-level expertise that will be essential in the future.

Last issue’s article implied that the BPS has acted undemocratically. An objective eye would recognise that the BPS Council, like that of many learned societies, is elected and mandated to take action on behalf of members without consultation, and has represented pharmacology at the interfaces between our profession, government and industry. The council has been a driving force in the society’s work, publishing a five-year strategy that prioritised safe and effective prescribing among other goals.

Where reform is needed, the society acts. The BPS gave its support to the All Trials campaign promptly, on 20 February, as soon as the council had seen and approved the proposal. Many significant organisations have been much slower off the mark. And our commitment to reducing harm to patients is evident from the leadership of BPS clinical pharmacologists, funded by the society, in building a Prescribing Skills Assessment for medical students in collaboration with the Medical Schools Council. Backed by online teaching modules, the PSA is currently being piloted.

The BPS has been accused of silence on homeopathy, yet its response to a consultation by the Medicines and Healthcare Products Regulatory Agency in 2005 was clear: “Despite many years of investigation, we have no convincing scientific evidence that homeopathic remedies work any better than placebo. Pharmacologists have noted frequently that most homeopathic products are diluted to the extent that they contain no molecule of active ingredient, that is, no medicine, which is highly misleading to consumers who are unlikely to recognise the expression ‘30C’ for example. Furthermore, there are serious concerns...that officially endorsed use of such remedies may put patients at risk of delayed diagnosis.”

To avoid any doubt, the BPS’s position is that there is no scientific basis for homeopathy. Homeopathy represents a failure to recognise the importance of evidence as a guide to making choices. It is the voice of science, not just pharmacology, that needs to be heard. The society’s collaborations with its sister societies and other scientific disciplines can only help when it comes to addressing this and similar failures of understanding.

Humphrey Rang is emeritus professor of pharmacology at University College London and president-elect of the British Pharmacological Society.

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Comments

Thanks to Humphrey Rang for pointing out the many good things that the BPS does.

I'm glad to hear that the ESHLSG is being revised, because, as I pointed out, two of its clauses seem unacceptable to me in their present form. I was surprised and disappointed that the BPS signed up to them. I hope they'll be changed.

On the question of mislabelling of homeopathic pills, I think Humphrey has got his dates a bit wrong. The BPS responded to the consultation, on 7 September 2005, with "We have no comments to make" (that is reproduced at http://www.dcscience.net/?p=5821).

In October 2006, I wrote to the then president of the BPS with two suggested drafts which I'd written, one of which is that reproduced in Rang's article. Although it was issued at the time, anyone who visits the BPS web site hoping for guidance on fringe medicine now will find essentially nothing.

And Rang has not responded at all to my comments about the absurdly misleading labels which the MHRA endorsed for herbal concoctions.

I realise that fringe medicine is not the job of the BPS, but it is big business and surely the BPS should be at the forefront of informing the public. More importantly, the BPS should be giving a lead to those who are pressing to make sure that all clinical trial data are released, and in condemning the recent attempts to conceal negative data.

Here's another point. Rang defends the BPS membership of ESHLSG, but fails to mention that first the Lancet and then the BMA withdrew their support. Nor does he mention that medical students and doctors launched a campaign, BadGuidelines.org, against the agreement. The Medical Schools Council, which also signed the agreement, said the scrutiny of the guidance has identified deficiencies in the current statement. Didn't they read it before signing? Rang says that the BPS is also working to improve the joint statement with the ABPI. That's good, but one must wonder why the BPS signed up to the original form.

"high-quality science to improve the discovery and use of drugs for treating disease". The very definition of pharmacology research.
I hope our nascent society for basic and applied pharmacology upholds similar ideals.

A good leaf to borrow

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