An article in The Guardian last week alleged that PR agencies in the US marketed an ailment as a means of marketing its cure, by the establishment of information groups, a strategy reportedly favoured in the UK, too, where strict laws have long prohibited the promotion of prescription treatments.
That drug companies back charities in the UK is undeniable. That Pfizer, the maker of erectile disfunction treatment Viagra, is a backer of the Impotence Association, and that Eli Lilly, which makes schizophrenia treatment Zyprexa, supports mental health charity Rethink is easily retrievable from the corporate websites of both. And it's worth stating that Pfizer and Lilly are typical of the sector rather than exceptional.
Critics - predominantly from outside the healthcare PR sector -- suggest that the fact bodies that lobby for the availability of new treatments on the NHS receive financial support from the pharma giants and their PR contractors appears to be a conflict of interest.
But the healthcare PR industry - restrained by regulations on its sector - remains unconcerned at the fears, convinced its actions are all above board.
Angie Wiles - deputy MD and UK healthcare chief at Cohn & Wolfe, whose New York office bore the brunt of The Guardian's criticism - says most firms deal predominantly with established independent health charities and support groups: 'We work with independent groups. Support groups should be independent and good pharma companies and good PR companies respect that. As far as I know, in the seven years I have been here we have never set up a patients group, although we did set up an information service for women over 50.'
It is information groups that are the key to disease awareness campaigns, and a regular feature of health PR strategy: 'PR companies in general set up information services, which can be anything from leaflets to websites to award schemes. They could be actively involved or a partial player in it. It often depends on the disease area where it helps raise awareness and discussion of a treatment when not much is known of the disease or its treatments, or disease management needs addressed,' Wiles says, even though she stresses that such actions are done within strict industry regulations.
She denies suggestions that by supporting information services firms are exerting pressure on regulators and doctors to make products more readily available on the NHS, or encouraging patients to ask for them: 'You can't directly promote drugs to patients and, at the end of the day, it's up to doctors to prescribe. NICE (The National Institute for Clinical Excellence) has said patients receiving older drugs are suffering as the funding isn't there.'
Red Door Communications co-founder Julia Tollis admits healthcare firms work closely with patient groups, but maintains that agencies and pharma companies act honourably in their dealings with the groups: 'We do a lot of work on condition awareness with patient groups, but they tend to be independent, well-known ones. They tend to receive funding across the board. They need to be seen as not in the pocket of the drug firms as they have an important role in lobbying on awareness of an ailment.'
But Tollis concedes that the proliferation of action groups for a multitude of ailments means funding from the pharmaceutical industry takes on added importance: 'There are patient groups for every condition which need to get money from somewhere, but with newer therapies it's harder to attract interest from broader donor areas.'
NICE director of comms Anne-Toni Rogers insists that lobbying acted out through third parties is not allowed to affect the process of making a drug available on the NHS: 'When we work with stakeholder groups one of the things we check out is the existence of any conflicts of interest.
We ensure that they are genuine groups, not those set up by pharmaceutical companies,' she says, citing the barring of purely industry-run groups from consultations.
'Clearly patient groups and manufacturers can have similar aims, and most of the patient groups have clear guidelines on how they interact,' she adds.
She accepts that the financial clout of the pharma giants is immensely valuable to campaigns, but reiterates that its exercise must be on the condition that the backers can have no influence on the content of the campaign.
While NICE protocols prevent industry fronts exerting undue influence on drug licensing, they are still capable of generating media coverage and swaying public opinion. And until there is sufficient transparency to generate confidence in the running of all such campaigns, critics will continue to find much fodder in them.