Wednesday, 28 October 2015

Harvey’s a hero: fighting on the pharmaceutical frontline

Adjunct Associate Professor Ken Harvey joined SPHPM last year in the Department of Epidemiology and Preventive Medicine (DEPM) and has had a keen research interest in medicinal drug policy and complementary medicine.

He regularly contributes to The Conversation on policy and ethical issues related to the pharmaceutical industry, the Therapeutic Goods Administration (TGA) and complementary medicine.

Dr Harvey graduated in medicine from the University of Melbourne in 1967 and originally specialised in medical microbiology and infectious diseases.

“I became interested in antibiotic-resistant micro-organisms while working at the Royal Melbourne Hospital in the late 1970’s, especially problems with hospital-acquired infection due to Methicillin-Resistant Staphylococcus Aureus (MRSA),” Dr Harvey said.

This interest in antibiotic resistance developed into a study of antibiotic prescribing and then the forces at work on the pen that writes the ‘script'.

“Not surprisingly, our drug audits found that antibiotic guidelines had only a limited impact in improving prescribing practice. We recommended using older narrow-spectrum antibiotics where one could and keeping newer, more expensive, broader-spectrum antibiotics in reserve for resistant organisms,” he said. This was in conflict with the promotional message from the pharmaceutical industry that could be paraphrased as, “you can’t afford to be wrong, prescribe expensive, broad-spectrum blundermycin for everything”.

This led to setting up a multi-disciplinary group to write evidence-based “Antibiotic Guidelines”, both as an aid to teaching and as an audit standard to measure appropriate antibiotic use.

This eventually resulted in a move from The Royal Melbourne Hospital to the School of Public Health at La Trobe University where he focused on medicinal drug policy. During that time, he worked with AusAID, the World Health Organisation and Health Action International on improving medicinal drug policy in the Asia-Pacific region.

Fast forward a few decades, and according to Dr Harvey, the conflict between the profit-orientated pharmaceutical industry and the public health goal of cost-effective, appropriate drug use is still ongoing today.

“For example, I lecture pharmacology students on ‘Drug promotion, advertising and ethical relationships with industry’ and I also run a session on case studies in complementary medicine for the MBBS prevention science teaching,” he said.

“I became interested in complementary medicines because there use is out of all proportion to the limited evidence supporting such products. In addition, complementary medicine promotional messages are often misleading,” he said.

Last year, Dr Harvey supervised the SPHPM Summer Vacation Scholars Program on complementary medicine research which resulted in a publication in The Conversation on work the students performed, “Krill oil marketing: a case study of Australia’s broken regulations”.

“Few consumers understand that most complementary medicines (labelled Aust L) are not evaluated by the TGA to see if they work. In addition, there are no effective sanctions for misleading promotion,” Dr Harvey said.

“Together with colleagues from consumer groups I’ve been agitating for a regulatory system with teeth”.

Dr Harvey and consumer groups he works with would like to see mandatory plain language labelling of Aust L products and legislation for timely and meaningful sanctions for advertising violations as well as increased and better targeted post-marketing surveillance and reporting by the TGA.

“I enjoy engaging consumers and students about the issues I’m passionate about assisting organisations such as the Consumers Health Forum, Choice, Australian Skeptics and Friends of Science in Medicine on policy issues,” he says.

“Although I’m now semi-retired and in the twilight of my career, I’ve greatly appreciated my Monash adjunct appointment, both for facilitating my involvement with policy issues and postponing my eventual retirement”.