Medicine Re-Discovers its Integrity




Med schools, journals fight big pharma’s sway

Even as new guidelines are set, potential for conflict remains, say many


Dr. Catherine D. DeAngelis, editor of the Journal of the American Medical Association, says the pharmaceutical industry’s influence on medicine is “so blatant now you’d have to be deaf, blind and dumb not to see it.”

updated 3:21 p.m. ET, Wed., Sept. 10, 2008

TRENTON, N.J. – Just about every segment of the medical community is piling on the pharmaceutical industry these days, accusing drugmakers of deceiving the public, manipulating doctors and putting profits before patients.

Recent articles and editorials in major medical journals blast the industry. Medical schools, teaching hospitals and physician groups are changing rules to limit the influence of pharmaceutical sales reps. And three top editors of the prestigious New England Journal of Medicine last month publicly sided against the drug industry in a U.S. Supreme Court case over whether patients harmed by government-approved medicines may still sue in state courts.

As more voices have called for change, new guidelines for how drugmakers and doctors should interact are coming from both industries, and doctors say some abuses of the past have ended. But the industries’ dealings remain fraught with potential conflict because the sectors depend on each other so much — medicine on drugmakers’ research dollars and drugmakers on the credibility researchers give them.

“The influence that the pharmaceutical companies, the for-profits, are having on every aspect of medicine … is so blatant now you’d have to be deaf, blind and dumb not to see it,” said Journal of the American Medical Association editor Dr. Catherine DeAngelis, a longtime industry critic. “We have just allowed them to take over, and it’s our fault, the whole medical community.”

In an April editorial in her journal, DeAngelis noted two studies indicated past reports about Merck & Co.’s withdrawn pain reliever Vioxx frequently were penned by ghostwriters and that reports on some Vioxx studies minimized the risk of death. Merck has denied the charges.

“Manipulation of studies and publications by the pharmaceutical and medical device industries is either increasing or there has been more exposure of these practices,” she wrote.

‘We should say “Enough!” ‘
She said industry influence includes swaying doctors and medical students to their brands with gifts, funding research at top teaching hospitals but keeping control of the studies and results, failing to disclose study authors’ conflicts of interest, even taking over the continuing medical education system for doctors by running courses on new treatments. Critics say such courses are taught by company-paid speakers who often promote expensive new drugs over older, cheaper ones.

“We should all get together and say, ’Enough!”’ DeAngelis said.

Already, top journals are listing study authors’ conflicts of interest, and dozens of medical schools and medical specialty societies are barring gifts to doctors and limiting their other financial ties to industry. Some schools bar professors from being paid drug company speakers. And one expert noted drugmakers have stopped giving cash prizes to medical students for presenting favorable research on their drugs at conferences. …..

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