Marketing Rx&D: rebuttal
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* Michael Yeo

My “focus”1 was not the above-referenced change to the Rx&D code as such. Rather, my aim was to draw attention to the silence about this not inconsequential change in the joint announcement,2 which conveys the impression that the revised code is a step toward harmonization with CMA policy.3 When the change the announcement trumpets is read together with the change in the opposite direction, which it inexplicably fails to mention, the revised Rx&D code4 is in fact two steps back. I am thus left puzzled about the reason for this announcement and concerned that the CMA may be wavering in its commitment to the principle at issue. 

Dana Hanson says there will be “further discussions” with Rx&D to bring their code “fully in line with CMA's guidelines.” However, he also indicates that consideration will be given to changing the CMA guidelines to include provisions regarding faculty development. This is good news for Rx&D, who can be expected to market and justify the “two steps back” provision in their revised code (Section 4B.2) under precisely this rubric! Perhaps the foreshadowed changes to the CMA guidelines will bring them sufficiently in line with the revised Rx&D code that, in turn, little more than a tweak or two to the code will be sufficient to bring it “fully in line with CMA's guidelines” (once revised)? 

Time will tell. I expect I will not be alone in watching for further developments with keen interest. 

𝛃 See related articles pages [1273](http://www.cmaj.ca/lookup/volpage/168/1273?iss=10) and [1274](http://www.cmaj.ca/lookup/volpage/168/1274?iss=10)

## Footnotes

*   *Competing interests:* Dr. Yeo was an ethicist with the CMA from 1997 to 2001.

## References

1.  1. Yeo M. Marketing Rx&D: one step forward, two steps back [editorial]. CMAJ 2003;168(10):1273-4.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTY4LzEwLzEyNzMiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTY4LzEwLzEyNzUuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. Elston MJ, MacKean P, McDonald JWD, Hanson DW. Rx&D code of marketing practices [announcement]. CMAJ 2003;168(6):714.
    
    

3.  3. Rx&D: Canada's Research-Based Pharmaceutical Companies. Code of marketing practices. Revised Jan. 2003. Available: [www.canadapharma.org/Industry\_Publications/Code/code\_e.html](http://www.canadapharma.org/Industry_Publications/Code/code_e.html) (accessed 2003 Mar 28).
    
    

4.  4. Canadian Medical Association. Physicians and the pharmaceutical industry (update 2001) [policy statement]. Available: [www.cma.ca/cma/common/displayPage.do?pageId=/staticContent/HTML/N0/l2/working_on/ppi.htm](http://www.cma.ca/cma/common/displayPage.do?pageId=/staticContent/HTML/N0/l2/working_on/ppi.htm) (accessed 2003 Mar 28).