Dear Editor,

We were extremely surprised by Dr Reed’s letter regarding the above paper, so we wondered if she had read it thoroughly.

She suggests there may be a conflicting interest, Archives rather terms this competing interest which they define as “when professional interest (such as patients welfare or the validity of research) may be influenced by a secondary interest (such as financial or personal rivalry).

Abbott laboratories is an international company (not UK concentrated as implied by Dr Reed) which markets Palivizumab, as RSV prophylactic agent for use in prematurely born infants with or without bronchopulmonary disease and term born infants with certain types of congenital heart disease.

Our paper was about the healthcare utilisation of preschool children who had or had not required home oxygen on discharge from the NICU – it was not about RSV prophylaxis.

The JCVI already in 2002 following the paper by Thomas et al working at St George’s has recommended RSV prophylaxis to prematurely born infants with BPD who had been discharged home on oxygen, as Thomas has shown this was cost neutral.

Thus we conclude Dr Reed’s implied criticism of Archives to be unfounded and hence unjust.

Yours sincerely

Professor Anne Greenough
Professor of Neonatology and Clinical Respiratory Physiology

Dear Editor,

Having read the research article published by Greenough et al. regarding home oxygen use and healthcare utilisation, I was surprised to see that the fact that Abbott Laboratories had funded the research nurses for the study was only included as an acknowledgement rather than a potential conflict of interest. Abbott Laboratories have a very strong commercial interest in children with bronchopulmonary dysplasia, the subjects of this study, as they are the manufacturers of 'Synagis' or Palivizumab, an extremely costly and heavily-marketed product used in this group of children. Funding of staff by charitable foundations could appropriately be listed as an acknowledgement, but commercial organisations rarely spend money unless there is direct or indirect potential for gain, and surely this is at least a potential conflict of interest for the research team. Those of us who have worked in paediatrics in the UK may automatically be aware of the commercial interest of Abbott Laboratories in ex-premature infants, but the Archives of Disease in Childhood has an international readership and has a responsibility to its wider audience to clarify these issues.