The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Photo of Shai Mulinari. Private photo.

Shai Mulinari

Associate Professor | Senior Lecturer

Photo of Shai Mulinari. Private photo.

Authors’ reply to Fell


  • Shai Mulinari
  • Piotr Ozieranski

Summary, in English

Fell, from the Prescription Medicines Code of Practice Authority (PMCPA), the self-regulatory body of the Association of the British Pharmaceutical Industry (ABPI), agrees with our overarching point that healthcare professionals and organisations have an important role in responding to any formal sanctions that are applied by the PMCPA and ABPI.12 For healthcare professionals and organisations to able to respond, however, they need more information about what the companies breaching the ABPI code have done. We therefore look forward to the PMPCA considering our suggestions to improve transparency by making its audits publicly available and by requiring companies that are publicly reprimanded by authority to inform their collaborators about the offences and any remedial action taken.

Fell sees the increasing number of breaches of the ABPI code ruled over time as a positive development, as it “shows that people feel confident using the self-regulatory system to raise concerns.” Although this interpretation is certainly possible, the obvious counterpoint is that the increasing number of breaches primarily shows that many companies are engaging in unethical marketing, which can hardly be seen as positive.

Furthermore, although some people exposed to unethical marketing do submit complaints to the PMCPA, most do not, as we point out in our article. In other words, there is most likely a large under-reporting to the PMCPA. In addition, people might be submitting complaints to the PMCPA just because it is the only way to complain about company misbehaviour (as the Medicines and Healthcare Products Regulatory Agency strongly encourages people to complain to the PMCPA).

Finally, although it is true that the total number of complaints from individuals to the PMCPA has gone up in recent years, a detailed breakdown shows a very marked decrease in complaints from competing drug companies. It would be concerning if this was because companies do not feel confident in using their own self-regulatory system to raise concerns.


  • Sociology

Publishing year





British Medical Journal



Document type

Journal article (letter)


BMJ Publishing Group


  • Sociology




  • Following the money: cross-national study of pharmaceutical industry payments to medical associations and patient organisations


  • ISSN: 1756-1833