There is strong evidence that medical researchers’ financial ties to their industry funders may directly influence their published positions in supporting the benefit or downplaying the harm of the products they are “studying”.
For example, there is often a demonstrated difference between internal drug company documents about the research trial results that they fund, and the articles reporting that research that end up in the medical journals that your doctor reads. The New England Journal of Medicine has referred to this practice as ‘selective outcome reporting’.
But for the sake of clarity, let’s just call it ‘lying’.
In other words, as a dull-witted heart attack survivor whose doctors have prescribed a fistful of daily cardiac meds, I have no clue which of those drugs has been recommended based on flawed research or tainted journal papers that have essentially been bought and paid for by the drug company who made my drugs. And, worse, neither do my doctors.
Here’s another textbook example: Dr. Mohammed Hassan Murad of Mayo Clinic reviewed* 202 published journal articles that addressed the now-recognized association between heart attack risk and the diabetes drug Avandia, made by drug giant GlaxoSmithKline. Among the journal article authors who (erroneously) concluded that Avandia does NOT increase the risk of heart attack, 86% had financial relationships with GlaxoSmithKline. But among authors of articles offering unfavorable reviews of Avandia, only 18% had relationships with GSK. For more on what can happen to you if you market your drugs like this, see the New York Times report, GlaxoSmithKline Settles Investigation with Record $3 Billion Fine in Avandia Settlement
This financial conflict of interest problem is now considered so pervasive, in fact, that those who do the studies are being studied themselves.
Regrettably, it turns out that medical researchers working on clinical trials “may not always follow best practices” when it comes to avoiding or minimizing the powerful influences of those who give them money, which is the charitably tactful assessment by Dr. An-Wen Chan, also of Mayo Clinic.
Reporting on his study of financial conflicts of interests (specifically when it comes to Big Pharma-sponsored drug trials), Dr. Chan told Heartwire interviewers:
“Clinicians and researchers need to be far more aware going into studies about what potential conflicts of interest might arise with their drug trial sponsor, and take steps to prevent them early on.”
Dr. Chan and his colleagues asked 1109 researchers about their experiences with clinical trials conducted from 2001 to 2006 (across all medical specialties), inquiring specifically about these “best practices.” These included:
1. Externally regulated best practices:
- Were the trials registered?
- Was there an institutional review of trial budgets and contracts?
2. Self-regulated best practices:
- Did researchers have to sign restrictive confidentiality clauses?
- Were investigators expected to provide their sponsors access to study data?
- Did the investigators control all decisions about study design, analysis, interpretation, and manuscript content?
Dr. Chan reported that “clear problems” were identified – particularly in the industry-sponsored trials – when researchers were asked these key questions:
- Had research investigators taken a lead role in such decisions as study design, analysis, and data interpretation?
- Were ghost authors involved in the preparation of the study’s manuscript before submitting to a medical journal for publication?
- Did they have to sign restrictive confidentiality clauses with the corporate funders of their research?
Conflicts of interests do not, of course, just impact researchers doing clinical drug trials. Consider these other examples of financial conflicts of interest reported from just one prestigious institution (Harvard University) as reported by the Center for Science in the Public Interest and their Integrity In Science conflict-of-interest project:
- a Harvard pediatrician is paid by The Sugar Association to write good things about children and sugar
- a Harvard doc is paid $100,000 cash by a major drug company to testify in court that their recalled drug does not cause deadly heart attacks
- a Harvard astrophysicist banks over $630,000 in payments from ExxonMobil in exchange for co-authoring a report questioning climate change.
Which of these Harvard “experts” would you trust?
- “Integrity in Science” – Who’s Paying the Piper?
- When Medical Research Is Funded to Favour the Drug, Not the Facts
- Does The Medical Profession Need To Wean Itself From its “Pervasive Dependence” on Big Pharma Money?
- “We Never Imagined People Would Think of Osteopenia As a Disease”
- The Medicalization of Everyday Life
- Medical Miracle Breakthrough In The News? Not So Fast!
- New Desire Drug Claims That Sex Really IS All In Her Head
- The Business of Prostate Cancer: Putting Profit Before Patients
- Partners in Slime: Why Medical Ghostwriting is So Alarming
- Harvard’s Ethical Ultimatum to Doc: “Give Up Big Pharma Moonlighting Jobs, or Lose Harvard Teaching Post“
- Harvard Cozies Up With Big Pharma: about a U.S. Senate investigation of the poster boy of industry conflict of interest investigations. This report found Harvard’s Dr. Joseph Biederman had “taken more than $1.6 million in payments from Johnson & Johnson. He’d been a prominent backer of childhood use of the anti-psychotic drug Risperdal. Massachusetts General Hospital expressed concern that Biederman and J&J worked together to promote Risperdal’s use in children, rather than for scientific or educational purposes.”
* Murad MH. Association between industry affiliation and position on rosiglitazone and cardiovascular risk: A systematic review. Preventive Medicine 2010; February 19, 2010; Washington, DC. Abstract 212694.