Harvey A. K. Whitney lecture. Interdependence in pharmacy: risks, rewards, and responsibilities.

The importance of interdependence in the future of the pharmacy profession is discussed. In politics, economics, business, and health care, the pursuit of individual independence is giving way to the realization that interdependence is necessary for future success. Communication technology and the accelerated growth of new knowledge foster interdependence. When one sector of society creates large and interdependent structures, other sectors with which it interacts must do likewise to retain a balance of power or influence. Interdependence--sharing ideas and information--has helped institutional pharmacists to gain influence in health care; with this influence have come responsibilities and risks. Pharmacists' contribution to clinical research is increasingly respected and needed by the pharmaceutical industry. However, compromised ethical standards are at risk when drug companies reward pharmacists for research or presentations involving their products or for influencing prescribing of these products. Industry is also dependent on pharmacists making purchasing decisions. Biotechnology products in particular set the stage for potential conflict of interest. Pharmacy should formulate guidelines defining standards of conduct; ASHP is encouraged to establish a commission on ethics. Guidelines might require (1) that pharmacy and therapeutics committee members fully disclose any relationship with manufacturers of drugs considered for the formulary and (2) that pharmacists' publications in industry-sponsored literature and presentations at industry-supported educational programs be objective and scientifically sound. Successful organizational leadership will require the ability to identify opportunities for interdependence.