Here’s another story – Powerful proponent of psychiatric drugs for children primed for a fall — about the problems with MDs taking money from Big Pharma, whether as researchers, guest lecturers at science conferences, etc. Dr Joseph Biederman, chief of the Massachusetts General Pediatric Psychopharmacology Clinic, is under investigation by Harvard University and the National Institutes of Health for not reporting fees he received from drug companies. In an ongoing trial, Biederman claims that
drug company dollars (declared and undeclared) have not influenced him or his research. He had agreed temporarily to sever most of his financial ties with the drug industry pending the outcome of the ongoing inquiry.
He claims his science and publications are pure, supported by a peer-review system that is supposed to verify accuracy and authenticity. Finally, he challenges as office gossip reports of his legendary anger and intolerance of those who disagree or don’t support his proposals.
Yet as the story goes on to note,
Virtually all researchers say they are not influenced by drug company money. Doctors rarely out-and-out lie about their research, but spin influences how a study is set up, its statistical analysis and interpretation. Research on drug studies repeatedly shows that drug trial results are tilted toward a positive description of the drug’s effects when the research is funded by a drug company rather than the government or an independent agency.
Big Pharma money is most powerful when promoting Biederman’s research and point of view over competing models. Drug companies copy and mail his important papers on psychiatric drugs to every American physician working with children. A member of the Biederman team is at every important meeting on children’s psychiatric issues and medical education. Their presence, and often the conference, itself, are supported by drug industry dollars.
Nancy Walton at the Research Ethics Blog has a smart commentary on the importance of thinking about relationships and COI, in the context of MD prescribing and drug reps,
Personal relationships, conflict of interest and ethics.
In order to respond to allegations of COI related to studies published in its journal, the Journal of the American Medical Association, is instructing those alleging COI to keep quiet until the Journal can fully investigate the claims.
As these new stories rightly note (in particular, the WSJ story), such a policy raises important concerns about how journals can and should deal with claims of COI. Should it be only the journals who should investigate? What if they take many months (which is a long time in medical publishing) to investigate, and don’t appear, at least to some in the academic community, to be taking the issue sufficiently seriously? Finally, what about the place for a more vigilant peer-review academic community?
P.S., see this commentary in the Economist – Pity the messenger – which notes that,
The JAMA editorial explains that the new policy arises from a desire to “ensure a fair process of investigation and above all, to protect the integrity of science and the reputation of JAMA.” The first two goals are laudable, but the rule of silence seems designed with the third, rather more self-serving, goal in mind. If JAMA is not careful how it implements its new policy, that may yet work against the first two goals.
P.P.S (July 9): To follow-up, it looks like JAMA has backed down a bit on their policy: JAMA Eases Stand on Public Complaints About Conflicts; here’s the revised COI policy.
From the Effect Measure blog, and interesting commentary about researchers and involvement with Pharma funding.
The scientist as high class hooker and gigolo
The Conflict of Interest talk these days is all about doctors and medical school lecturers who are in bed with Big Pharma, but the bed is pretty crowded. Researchers are there, too. Not that this hasn’t been a topic of conversation. And not that researchers aren’t conscious of it and frantically trying to distance themselves from it. But it’s nice and warm under the covers and its a friendship with benefits, as the younger generation likes to put it…
From the American Academy of Family Physicians, some attention to the issue of COI — and its management — in the organisation of Continuing Medical Education events: Downloadable Fact Sheets Dispel Myths About CME Bias, Conflicts of Interest.
