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Recent discussions on the educational content of sponsored symposia at the BGS national conferences have reawakened interest in the nature of the Society’s relationship with the pharmaceutical industry.

Here we present two opposing points of view, neither designed to hi-jack the current policy of the BGS, but rather to prompt discussion. Where do you sit on this issue?

Educational Partnership, not product placement - speaking for the prosecution is Dave Beaumont:

Attendees of the sponsored evening symposium at Gateshead, on the subject of Falls, Fits and Faints will recall hearing a lengthy discourse on the merits of a new anticonvulsants in younger patients and a subsequent challenge to the speaker by a Society member as to whether the speaker wished to declare any conflict of interest relating to his presentation. At a previous meeting we thralled at the merits of Probiotic agents; interesting subject and maybe of relevance in certain situations, particularly in antibiotic related diarrhoea, but equally, I fancy there are topics more worthy of discussion at a national BGS conference.

Now we all know that the support of the pharmaceutical industry is vital to the financial success of our conferences and indeed, in their sponsorship of a variety of educational events. We also acknowledge that whatever the drawbacks, contact with representatives can be informative, especially with regard to new products. However, it is the nature of that relationship which needs to be questioned, not the fact of it. A recent article in the Journal of the Royal Society of Medicine outlined how the medical profession is complicit in the marketing strategies of drug companies, by being too passive in managing this relationship and through their involvement in a variety of drug company sponsored activities from funded research, presentations of this research at meetings, attendance at meetings to hear these presentations and by creating opportunities for opinion formers to speak to their colleagues. This is all fine but there has to be transparency where conflicts of interest exist.

Now we must not throw the baby out with the bath water. I personally do not take the view that our sponsored symposia universally lack educational content. I find those relevant to my field very helpful indeed but even some of those border on the promotional. So where might the BGS be considered complicit? Consider the “Falls” symposium mentioned above. The speaker in question gave his totally promotional segment based on locally derived audit data, in front of the BGS logo, introduced by one of the Society’s finest academic daughters. The details appear on our published programme and may well be reported in the medical press. So what control, as a Society, do we have over the content of these sessions that we seem to be enthusiastically selling off to cover essential costs at the risk of tacit promotion? In my view this was blatant product placement of the sort you might see in Coronation street.

I think this is unacceptable. We should take a polite but firmer line. Events such as sponsored symposia appearing alongside our national conference and under our banner should abide by a clear set of governance rules. For example;

• No promotion within the presentations
• Content of all presentations to be agreed with the Society in advance
• Topics to be pertinent to the health care of older people
• Speakers’ fees to be within limits agreed with the Society
• No photographic links of products with the Society’s logos, badges, or intellectual property to prevent apparent endorsement
• Pharmaceutical company presence to be provided through stands or displays, separate from but adjacent to the meeting room.

What we need is a less laissez-faire and more professional approach to prevent the Society being compromised - a relationship based on an ethical, educational partnership, not promotion and product placement.

The other side of the coin - speaking for the defence, Michael Vassallo says:

The organisation of the British Geriatrics Society meetings is expensive. Registration fees over only about 50% of the costs of the meeting. Income needs to be generated from other sources and the huge majority of this comes from the pharmaceutical industry. They buy exhibition space and pay to organise sponsored symposia. Some BGS members dislike such sponsorship. However, the economic reality is that without the pharma industry it would not be possible to hold meetings of the quality expected. Even the most optimistic among Society members would not think that in this age of declining study leave budgets, members would be happy if the registration fees were doubled. If anything, many think that the meetings are already too expensive.

Let us remember that pharma companies self regulate very effectively to a high standard through the ABPI. They are private companies that have been exclusively responsible for the development of new drugs that have benefited millions of patients, and have led to well documented improvements in length and quality of life. So one can have sympathy with their wish to promote their products to generate a return on their investment, particularly if they are contributing to our CPD. We would probably be in a sorry state if government’s (right or left wing) were to be relied upon to take the responsibility of drug development. The pharma industry has made a significant contribution to health improvement and had it not been for them we would be practicing a very primitive form of medicine today.

Apart from being able to hold our meeting, do we get anything else from the industry? The issue of their involvement with and sponsorship of satellite symposia at BGS meetings is controversial. Critics cite the fact that some of the sponsored symposia at the BGS have been overtly promotional and of poor educational value. Lectures that are overly promotional and unscientific are both annoying to delegates and counterproductive to the pharma company. Although criticism may be justified, one should avoid the knee jerk reaction of labeling all symposia “educationally poor”. Despite the best intentions, even some of the presentations delivered in the plenary sessions of the main BGS meetings have been educationally poor. Self respecting companies pride themselves in high quality meetings that attract as many people as possible. The fact that a meeting starting at unsociable hours such 07:30 still manages to attract a substantial number of delegates is a reflection that the content is considered as largely worthwhile. People vote with their feet because the lectures cover important topics and are chaired and delivered by opinion leaders, many of whom are members of the Society. In addition, although a talk may be promotional, it does not mean that it lacks educational merit, provided that it is delivered in a scientifically sound way. Indeed, such symposia offer the opportunity to discover aspects of medicine or pharmacology that delegates would otherwise not know about.

If one looks at the number of meetings supported by medical representatives throughout the country, few can argue that the industry is a keen supporter of medical education and serves as a valuable resource. They often provide considerable resources unconditionally, and present opportunities of which even the critics have availed themselves. Our relationship with the pharma industry is a symbiotic one and we must ensure that future relations remain mutually beneficial.

Dave Beaumont
Hon Secretary
Michael Vassallo
Meetings Secretary