The BMJ Today: Waterpipe smoking and Pfizer launches fightback

pfizerPfizer steps up battle to defend control of Lyrica—Andrew Jack reports on how Pfizer has launched a charm offensive on UK doctors after a barrage of criticism over action to maintain exclusive control of the main use of its valuable pain drug pregabalin (Lyrica). Despite the expiry of the drug’s original patent, Pfizer holds a “secondary use” patent on the drug’s most popular indication: the treatment of neuropathic pain.

• In an open letter, also just published, Berkeley Phillips, Pfizer’s UK medical director, argues that Lyrica should remain partly protected from competition in order for the company to invest in research and development. “We have conducted over 50 clinical studies involving more than 12 000 patients specifically to assess the efficacy and safety profile of Lyrica for this condition alone,” writes Phillips. “It is only as a result of our investment in this additional research programme that millions of patients have had access to this important treatment to help manage their pain and improve their quality of life.”

shisha• Waterpipe smoking: does prevalence data underestimate true useage? A recent editorial in The BMJ highlights a worrying rise in waterpipe tobacco smoking, especially among adolescents and young people. A new letter questions the quality of some of the epidemiological surveys underpinning the prevalence data. If anything, the trend in smoking could be even higher, says Mohammed Jawad and Christopher Millett, because of the way the survey is constructed.

It uses a “gateway” question to enter the tobacco section, so that only those answering yes to the question “do you currently smoke on a daily basis,” enter the waterpipe section of the survey. Many young people won’t consider themselves smokers or realise that there’s tobacco in the product so will simply gloss over this section, according to the authors.

Rebecca Coombes is head of investigations and features. Email