Pharmaceutical Industry and Conflicts of Interest

This has been a topic here at ScienceBlogs, and elsewhere.  In
this post, I point out some of the blogosphere commentary, and provide
links to some commentary published in journals that might otherwise
escape widespread attention.  

href="http://scienceblogs.com/seed/2006/04/psychiatry_experts_linked_to_d.php"> class="linkTitle">Psychiatry Experts Linked to Drug Makers--
And?
The New York Times reported yesterday that many of the authors of the
DSM-IV, the sine qua non diagnostic manual (I'm 300.00, thanks for
asking) for mental health professionals had ties, either before or
after their involvement in creating the...

href="http://scienceblogs.com/cortex/2006/08/factoid_of_the_day.php"> class="linkTitle">Factoid of the Day From
today's WSJ: Studies of psychiatric drugs by researchers with a
financial conflict of interest -- receiving speaking fees, owning
stock, or being employed by the manufacturer -- are nearly five times
as likely to find benefits in taking the...

href="http://ronbeas2.blogspot.com/2006/08/in-pocket-of-big-pharma.html">In
the pocket of Big Pharma I have suspected for some time that
the medical profession in the United States was being driven and
controlled by the major pharmaceutical companies. the FDA certainly is.
Well buried in the back of newspapers today you will find this... href="http://www.truthout.org/issues_06/071306HA.shtml">Medical
Journal Says It Was Again Misled: For the second time in two
months, The Journal of the American Medical Association says it was
misled by researchers who failed to disclose financial ties to drug
companies...

The bottom line is that people are worried about the influence of
pharmaceutical companies on medical practice.  The concern
covers several potential lines of influence: by influencing prescribing
doctors directly, by influencing research results, by influencing the
publication of research, and by influencing the content of medical
education.  



These items were addressed in a set of editorials in the href="http://ajp.psychiatryonline.org/" rel="tag">American
Journal of Psychiatry: href="http://ajp.psychiatryonline.org/cgi/content/full/163/4/571">Conflict
of Interest; href="http://ajp.psychiatryonline.org/cgi/content/full/163/9/1481">Conflict
of Interest, Round 2; and href="http://ajp.psychiatryonline.org/cgi/content/full/163/4/569">Free
Lunch?

Also pertinent to this issue is the recent editorial in JAMA,
The
Influence of Money on Medical Science.



All of these are open-access articles.  Note that JAMA has a
collection of articles on the subject href="http://jama.ama-assn.org/cgi/collection/conflict_of_interest">here,
but not all of them are open-access.  There are 11 pages of
titles in the collection, so it obviously is a hot topic.  



Also of interest in this regard are the href="http://www.ama-assn.org/ama/pub/category/4001.html">AMA's
guidelines, and those of the href="http://www.phrma.org/principles_and_guidelines/">pharmaceutical
industry (PhRMA).  



It is a good sign that the major articles are freely available to the
public.  I have the impression that there is a reason for this
surge of interest in the matter.  Major news sources have been
quick to pick up on indications of impropriety, particularly regarding
conflicts of interest.  Journals want to come clean.
 I am sure that most of this is due to their inherent
integrity, but a little public scrutiny can't hurt.



In reading through these articles, I am impressed by the extent to
which there has been a systematic infiltration and influence of the
medical profession by medically-related industries.  As with
the medical publishers, not all of their interests are malevolent.
 Most are not.  I also have the impression that there
is a trend toward greater transparency.  



These efforts are still a little anemic, in my opinion, but the trend
is positive.  One thing I would like to add is that one
impediment to strengthening of the barriers to conflicts of interest is
the ego of most physicians.  It seems that many have the
impression that they are too smart to be susceptible to unseemly
influences.