The world expects instant gratification", a top AstraZeneca UK executive told MPs on the Health Select Committee, during his portrayal of the public's purportedly skewed perception of the risk/benefit balance of pharmaceutical products.

"Things seem to have gone completely out of balance in terms of public perceptions. Things are either wonder cures or killer medicines," asserted John Patterson, AstraZeneca UK 's executive VP of product strategy, licensing and business development.

His comments came out of a cross examination of pharmaceutical leviathans AstraZeneca (AZ) and GIaxoSmithKline (GSK) by the government's Health Select Committee, in which neither company accepted the possibility that they may have immorally pushed their products upon the British healthcare system, or covered up negative trial results.

There was no surprise that questions were levied during the hour-long session at the GSK representatives with regard to the alleged `hiding' of negative data for antidepressant Seroxat.

Dr Stuart Dollow, VP medical division, of GSK (UK), retorted that GSK published the results of all studies "whether negative or positive". He took the chance to "confirm that withdrawal effects have always been on Seroxat's label, but have been updated as more information became available".

Dr Patterson, at AZ UK, added that "it may take a long time to find side effects" that are relatively rare. Clinical trials involve a limited number of patients and so "unless [the drug] turns your ears green", side effects may not be fully appreciated until the medicine is rolled out and used much more widely.

Both pharmaceutical companies appeared to present their case soundly as a united front, and provided clear answers to the HSC's questions. They admitted that while the industry had perhaps not always done "everything it could" to prevent its decline in the public's esteem, conversely it had not always made known its own gripes, in a bid to balance out the picture.

The firms explained that Britain has become a tough place to do pharmaceutical business due to a public that calls increasingly for transparency and more information on the motives behind developing new products, and an inquisitive media that is unremitting in the search for the next big drug story.

Also present were Mr Eddie Gray, senior VP and general manager at GSK Pharma (UK) and Mr Chris Brinsmead, marketing co-president at AZ (UK).

GP TRAINING QUESTIONED

The second half of the HSC session saw Dr Richard Barker, director general of the ABPI, quizzed on the publishing of all clinical trial results, and the information provided to GPs from pharma companies.

The only physician on the HSC, Dr Richard Taylor, pursued a line of questioning on the suitability of GPs to make an informed decision to prescribe a drug, when one bears in mind that [citing Dr Barker's own words] "the promotional efforts of the [pharma] industry represent around I I minutes of GPs' weekly time", and that the pharmacology constituent of a medical student's training is 'barely adequate'.

"I'd hesitate to give a simple answer to that; it's a very good question," Dr Barker replied, admitting that GPs cannot necessarily make a "critical analysis".

Separately, Dr Barker noted that the pharmaceutical industry and its efforts should be more highly regarded by the public but that it would necessitate a culture change for it to happen.

"We have tended to consolidate the posi­tives - and forget rather quickly when new medicines come forward - and concentrate on the negatives. We can only get the benefits if we create a culture that is accepting of new medicines," he said.

Dr Taylor's next line of enquiry concerned the means of policing a common clinical trials data register. He also asked how long pharma firms should have to publish their results.

Dr Barker explained that there would be "no mileage" in firms posting information that is misleading, or skewed, on the common trials data website, and advised the panel that one of their recommendations to the industry could be that pharma firms must post this data online as soon as possible.

On the tricky topic of trust, Dr Barker added: "Prescribers, the public and regulators need to trust the industry, in order for promotional information to go to the people it should, the way it should."