The BMJ Today: Are you closer to pharma than you think?

BMJ_pharma_cover• Are you closer to pharma than you think?
36 English clinical commissioning groups (CCGs) have been involved in medicines management programmes either directly or indirectly paid for by pharma. In a BMJ feature, Margaret McCartney examines the different types of relationships in practice, the potential benefits and harms that can arise from these and what patients know about these relationships.

older_woman• Is there a second chance for an Alzheimer’s drug?
Hopes rose again this week for an Alzheimer’s disease drug which looked like it had reached the end of the road following phase III trials in 2012. However, this week the manufacturer announced new results from a secondary analysis of the trial data on solanezumab that suggested a small, sustained effect in patients with mild disease. But is it too early to raise our hopes again? Read the full details of the analysis in Nigel Hawkes’ news story.

older_woman_stretching2• Better balance, fewer falls
Falls are a recurrent problem in the elderly population and how to help reduce them is an important question. A randomised controlled trial found that a two year exercise and balance programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling. Read the full research paper and the accompanying editorial on

pills• Is the US medicines bill a colossal mistake?
A 350 page bill proposes major changes to America’s central medical institutions. The bill aims to boost funding for the National Institutes of Health and encourages the FDA to broaden the types of data it considers when evaluating new drug or device applications, allowing for expedited review and approval of new medicines based on trials using surrogate endpoints, in vitro data, animal studies, modeling studies, and smaller, early stage clinical trials in humans. In a feature briefing this week, Peter Doshi looks closer at the bill and the critics’ concerns about the implications for drug and device safety.

Sophie Cook is clinical reviews editor, The BMJ