Let's be clear: this is not a UK-only issue. However, the debate over clinical trial data disclosure has come to the boil this week in the UK, fuelled by the concentrated heat generated from the publication of Bad Pharma by Ben Goldacre, a book which levels criticism at the industry, regulators, doctors and academics for a wide range of issues including drug marketing practices, conflicts of interest and, to a large extent, data disclosure.

Goaded by Goldacre perhaps, a conservative member of the UK Parliament Sarah Wollaston, a family doctor, raised questions and secured a hearing with senior figures at the Department of Health for leading academics and doctors who were campaigning for mandatory full trial disclosure and enforcement. In her words, the campaigners "remain concerned that not enough is being done to see how we can make sure that all historic data and future data is released to the public domain".

In many recent proclamations, including the ABPI's response to Bad Pharma, industry has sought to distance itself from previous malpractice, claiming that the issues highlighted in the book are largely historic and that it now embraces transparency. That, largely speaking, has been the line not only from industry associations like the ABPI, but also from individual companies.

With this in mind, and given the commitment to revealing data and the claims that this has already been borne out by actions expressed by many big pharma companies, a question must be asked.

"Why not embrace mandatory disclosure?"

For those companies already making clinical trial information available in a free and open manner, it surely makes sense to make such exemplary behaviour mandatory, thereby holding all companies to a similar high standard. This also raises the barrier to entry for competitors, especially for competitors based in countries where regulatory oversight is unfocused and where best practice could be better.

Industry doesn't buy that argument, it seems.

Scrip asked the ABPI if it would support legislation to make it universally obligatory to publish clinical study reports, both new and old, relating to currently available drugs and to those that are in development or have been discontinued. We also asked if the association could identify potential problems with such legislation, and propose ideas for avoiding or overcoming them.

In response to direct questions, the ABPI took great care over a four paragraph response which still managed not to say whether it would support legislation. Or whether it would not. For brevity here, you can find the response in the deeper reaches of Scrip's vaults (scripintelligence.com, 29 October 2012).

Providing a European perspective, Richard Bergström at the European Federation of Pharmaceutical Industries and Associations (EFPIA), noted that the legislation is already there for approved medicines, and referred to a joint EFPIA/IFPMA /JPMA /PhRMA position issued in November 2009, in which the industry committed to making information available on ongoing clinical trials through clinical trials registries, and on the results of clinical trials, through clinical trials results databases.

However, the IFPMA portal, billed by IFPMA as "a single user-friendly entry site to facilitate access", is less a magical door and more a set of interlocking wormholes. Abandon hope, all those who enter here expecting translucently detailed clinical data.

With trepidation, Scrip asked this global Hitchhiker's Guide to the universe of trials information about Roche's flu drug Tamiflu. The results were partial and unsatisfactory.

Some of the items listed failed to open and repeatedly generated error messages.

Others linked to the NIH's clinical trials website, clinicaltrials.gov, and appeared to show that trial data had not been posted within a year of completion (and thus was in breach of US regulations).

And, illustrating the circular direction nature of time and information, the "history of changes" links on another item linked to clinicaltrials.gov led not lead to the history of entries for that particular trial, but to the IFPMA portal home page.

Yes, this was a cursory investigation. But the conceptual problem for a portal purporting to be a comprehensive source of clinical trials information is that any gaps destroy its comprehensiveness. It is clear that the IFPMA portal neither contains full data nor functions properly. The IFPMA portal is not a real solution to the real need for broad data disclosure.

EFPIA acknowledges this. "I agree that the reconciliation between study protocols (such as on clinicaltrials.gov) with final publications (and maybe as abstracts before) and regulatory submissions is far from perfect," Mr Bergström told Scrip. "This is work in progress for everyone."

Mr Bergström said: "Ultimately, I think that the regulatory agencies should be the normal source for consolidated information" on the grounds that "They approve all the trials and they get all results (at least from the pharma industry, academics and devices are different)".

He also emphasised the contention that "industry is fully supportive" of disclosure efforts.

Mr Bergström might want to pass that that thought on to EFPIA's member companies, especially the bits about "fully" and "supportive".

When asked about their own policies and practices, and on whether they would support legislation, some leading European pharma companies failed to respond (Roche, Sanofi).

Other dwelt in some detail on their own disclosure practices, and their belief in the principle of transparency, but skirted the issue of whether they would support legislation to make all clinical trial data publicly available.

AstraZeneca said that it registers and posts the results of all clinical trials at all stages of development regardless of whether they are favourable or unfavourable to the company in compliance with our legal and regulatory obligations". It posts all results within one year of study completion for already marketed medicines or within a year of a public announcement to discontinue further development of an unapproved medicine. For new medicines its policy is to disclose study results within 30 days of its regulatory approval.

"We believe firmly in the principle of transparency for clinical trial data, and that companies conducting clinical trials must meet their obligations in this regard," it said.

But on the need for further legislation, its answer was not direct: "Since we are compliant with our legal obligations to register and post study results, additional legislation to enforce such a requirement will not impact how we operate at AstraZeneca."

Novartis was briefer and also avoided the legislation question: instead it noted its own recognition of the importance of informing the public about the results of its interventional clinical trials, regardless of the outcome. "In alignment with the IFPMA and the WHO, Novartis has taken several important steps to ensure that information about clinical trial results reach the public in a timely and balanced manner," it said, and noted that it posts the results of its clinical trials on its publicly available clinical trials database, www.novctrd.com and/or at clinicaltrials.gov. The Novartis database contains a link to its own position on "Disclosure of Clinical Research Information", but this link leads to an error message.

Over at Boehringer Ingelheim, all Phase I-IV trials are registered prior to initiation on clinicaltrials.gov, including postmarketing surveillance, expanded access and compassionate use programmes and trials not conducted in the US, which it notes exceeds its legal and regulatory requirements. It also makes public many trials on the EMA's much maligned EU clinical trials database via EudraCT. As for its results, these are posted on clinicaltrials.gov and on its own website, and it says it is working with EFPIA and the EMA to establish a similar process and technical solutions for structured disclosure via EudraCT. Like other companies, it expresses support for the principle of transparency. But would it support legislation to require clinical trial data to be made publicly available?

Again the answer from the company was as foggy as a very foggy thing.

"Boehringer Ingelheim is considering providing access to patient level clinical trial data of its approved medicines and discontinued investigational medicines to interested parties provided that a number of practical, legal and policy issues have been addressed (e.g., patient confidentiality/ data privacy), that confidential information relating to intellectual property will not be disclosed, and that there is a qualified analysis plan available with the data request. Boehringer Ingelheim is looking forward to the upcoming "Workshop on access to clinical trial data and transparency", which will be hosted by the European Medical Agency (EMA) on 22 Nov. 2012 in London, where these topics will be discussed," was its less than crystal-clear response.

GlaxoSmithKline, meanwhile, recently drew much publicity for its commitment to publish all clinical trials data, though this will only include data since 2007 on globally conducted trials and in the case of local and regional trials, only those initiated after January 2013. It explained to Scrip that it chose those dates because then most studies would be in standardised data formats, making them more readily anonymisable and navigable. It did also note that its commitment is "about embracing openness" and that it continues to look at other requests with the "aim to share as much as we can, depending on practicalities, to support genuine scientifically valid requests".

The company noted that this will apply to all licensed medicines and discontinued pipeline assets, not just those in current use. It is clearly enthusiastic about increasing transparency, and says its "ultimate goal is to see the clinical research community develop a broader system where researchers can access data from clinical trials conducted by different sponsors". It hopes "the experience gained through our initiative will be of value in developing and driving this wider approach which we enthusiastically endorse". But even GSK stops short of calling for new legislation.

The Institute of Clinical Research may be touching on one of the issues when it stated on 23 October that "the European Medicines Agency has announced that it will proactively publish clinical trial data and enable access to full data sets by interested parties. A number of practical and policy issues need to be addressed before complex data sets can be made available."

Perhaps it is all about "practical and policy issues", perhaps it is for reasons of diplomacy, perhaps it is fear of additional bureaucracy, perhaps it is a belief that unilateral action can achieve faster results than setting up global mechanisms for defining, collating and standardising information; but whatever the reason, pharmaceutical companies individually or collectively evade the question.

With the gathering momentum from campaigners like Ben Goldacre combined with both the global spread and speed of the internet, this seems to be an increasingly risky strategy. How long before the next 'drug disaster' – as the emergence of the next post-hoc-predictable adverse side effect profile will be dubbed by the professional pharma skeptics – concentrates the pan-corporate mind on addressing this problem once and for all? And when it arrives, how much positive light will shine on a pharmaceutical industry that has skirted the issue so often?

Why not embrace the information age, embrace mandatory disclosure now, and take this opportunity to work with governments on holding all participants in the drug development process fully to account and ensuring full clinical study reports, past and present, positive, negative and incomplete, appropriately redacted if necessary to protect patient and commercial confidentiality, can feed into the global body of knowledge that goes to enhance public health and refine and adapt treatment guidelines across the health spectrum?

For those companies which already 'follow best practice', there can be nothing to lose and plenty to gain.

Scrip invites your response, whether open or in confidence. After all, not all details have to be disclosed, do they?