Pharmaceutical firms are aligning themselves with patient groups in a bid to put pressure on the NHS. But will such a move empower or exploit the public, asks Barbara Millar

Any day now health authority and health board chief executives can expect to receive a spate of remarkably similar letters.

They will be from people with multiple sclerosis, asking what the authority's policy is on funding the drug beta interferon.

The reason they will be so similar is that they have been drafted , a long with almost identical letters targeted at MPs and MSPs, by a new organisation called Action for Access and included in a pack giving each chief executive's name and address.

At last week's launch of Action for Access, media doctor Hilary Jones said that 'this landmark information campaign. . . would empower people with MS to challenge HAs over the lottery of postcode prescribing' for beta interferon treatment.

It was 'unfair, illogical and cruel' that only 1.5 per cent of the 85,000 people with MS in the UK were getting the treatment, even though some 40,000 of them had a clinical need for it, he added.

What he omitted to mention, however, was that Ac t ion for Access has financial backing from drugs company Biogen, which, along with Schering Health and Serono, manufactures beta interferon.

A line explaining this was inserted into the media release at the insistence of Liberal Democrat health spokesman Dr Evan Harris, who was also at the launch.

'I insisted I would not speak unless it was made clear that funding was from Biogen, ' says Dr Harris. 'But it is legitimate that pharmaceutical companies work with patients and doctors.

'It is clearly unfair that patients are disempowered and, until the government is honest about covert rationing, then they are bigger baddies than the drugs companies.'

Dr David Perkin, a neurologist at Charing Cross Hospital in London who also spoke, says there is 'no dilemma' about Biogen funding the campaign.

'In no sense is this campaign directed to enhance one drug company's product, ' he says.

'We have not referred to any individual preparation at all.' But he admits that greater sales of individual drugs may result from the campaign, which is 'being directed to achieve more prescriptions of drugs overall in this country'.

The Biogen-backed campaign comes hard on the heels of a new television advertising campaign about incontinence, funded by Pharmacia and Upjohn, manufacturers of the market-leading drug for the condition.

And that follows an advertisement earlier in the year about fungal nail infections paid for by Novartis, manufacturer of a fungal nail treatment. So is this a calculated move towards trying to influence changes in the rules to allow drug companies to advertise directly to patients?

Or is it simply, as the Action for Access information claims, providing support for patients 'to take power into their own hands and campaign to get government funding or a higher local priority for beta interferon treatment'?

Simon Williams of the Patients' Association says it does not matter how patients are empowered. 'This campaign gives people the ammunition to fire at government and health authorities to come clean and stop the game of postcode prescribing, ' he says.

'It is not giving patients information on particular drugs, it is giving them extra information on drug options, to enable them to have a stronger dialogue with their doctor, so that it is not loaded on one side.'

Besides, adds Mr Williams, some 40 per cent of all Internet accesses are to health-related sites giving information on diseases and their treatments - evidence, he believes, that 'patients want more information'.

The code of practice covering drug advertising is policed by the Prescription Medicines Code of Practice Authority - set up by the Association of the British Pharmaceutical Industry to operate independently of itself.

A PMCPA spokesman says that anyone who has 'a genuine concern' about Action for Access would be encouraged to complain to the authority.

The code states that any information provided about prescription medicines to the general public must not be for the purpose of encouraging them to ask their doctors to provide a specific medicine.

'In general terms, there is nothing wrong with talking about a disease, without mentioning a specific product, ' says the spokesman.

But if only one company was marketing the treatment for a particular disease then there would be 'grave doubts' about any claims it made that information provided was of a general nature, he adds.

When a complaint is brought, the Code of Practice Authority examines the case and adjudicates on it, with the whole process in the public domain.

There is certainly a considerable amount of money at stake.

The cost of providing a year's worth of beta interferon treatment is about£10,000 for each patient and around 200 patients in an average health authority could potentially benefit from the drug. The cost could be as much as£2m for every HA every year -£200m on the NHS drugs bill for England alone.

Dr Perkin points out that trials are under way in the US looking at whether people in the very early stages of multiple sclerosis could have the progression of their disease modified if they were also treated with beta interferon.

'The cost implications of this drug could, therefore, be higher still, ' says Dr Perkin.

This causes great concern to Joe Collier, professor of medicines policy at St George's Hospital Medical School in London, who believes the Biogenbacked information campaign is 'nothing more than the cynical exploitation of patients'.

The drug company is 'using unpaid foot soldiers to serve its own ends', says Professor Collier.