Some little snacks or a buffet at a discussion on community-hospital relations, a departmental meeting, training session or a care home or pharmacy team meeting? Yes, why not, refreshments can be convenient, convivial and very welcome in the middle of a busy working day.

But no thank you, not when a pharmaceutical company is footing the bill, in the interests of "staying in touch with healthcare professionals". That is how we are insidiously influenced, instead of gathering impartial information on drug treatments.

Being able to say "no thank you" to firms seeking to influence healthcare professionals is crucial to obtaining information and training that prioritises patients’ best interests. It is also crucial when choosing a drug, especially when that drug does more harm than good and exposes patients to disproportionate risks. However, dozens of such drugs are on the market. Because pharmaceutical companies have been granted marketing authorisations and are allowed to keep promoting them.

It is better to pledge to saying "No thank you, we will not begin treatment with this dangerous drug, there are better options". Pledge also to saying, backed by robust evidence, "No thank you, we are going to discontinue this treatment as it is too dangerous", before serious problems arise. Knowing how to say "No thank you" is crucial if healthcare professionals are to do their job well.

©Prescrire 1 April 2017

"No thank you" Prescrire Int 2017; 26 (181): 87. (Pdf, free).