Leading pharmaceutical industry figures have defended attempts by drugmakers to forge links with healthworkers and consumers, in an online debate in the British Medical Journal.

A prominent critic of the industry, Marcia Angell of Harvard Medical School, says there should be no relationship between the drug industry and either prescribers or patients. "We need to stop accepting the fiction that marketing, whether to prescribers or patients, is good education," she said.

"Their major output now consists of 'me-too' drugs for mild or ill-defined conditions in essentially healthy people. This is because that market is big and more easily expanded than the market for innovative drugs for serious diseases," she added.

But leading industry figure argue there is a legitimate place for responsible collaboration. Gordon Coutts, general manager at Schering Plough UK said: "Joint working has the potential to create breakthroughs in how the UK tackles major health challenges including cardiovascular disease and teenage pregnancies."

He conceded there was a "consensus that the ban on direct to patient advertising of prescription drugs in Europe should remain". But he added: "No-one should have an exclusive right to provide the public with information about medicines. Patients should have unimpeded access to multiple sources of information, none of which can claim to be free of any possible bias.

"Ultimately there is no option but for each party - prescribers, patients, and the drug industry - to build trust with each other."

Richard Tiner, medical director at the Association of the British Pharmaceutical Industry, said the UK industry was "committed to a stable and pragmatic partnership with the government and the NHS on medicines – one that enshrines value for money, reward for innovation, and ensures greater availability of new medicines to patients".

Health policy analyst Scott Gottlieb, based in Washington DC, also said a pragmatic approach was possible, provided that drugs companies "focus more squarely on matters of advancing science, monitoring for safety, and improving health education". The BMJ commented that the debate was vital given that "the relationship between the drug industry, academia, healthcare professionals and patients was "widely believed to be at an all-time low".