Friday, August 10, 2012

Medical vested interests. Can you trust the doctors

A recent article 1 highlights the lack of openness in medical research and reporting. The study found that “only one in seven authors fully disclosed their conflict of interest in their published articles….. and that approaches to controlling the effects of conflicts of interest that rely on author candidness are inadequate and furthermore, journal practices are not robust enough and need to be improved.

The problem with this is that “high-profile “opinion leaders” may exert considerable influence on prescribing practices of doctors and the doctors may not even be aware that the opinion leaders are getting paid by the pharmaceutical companies.

For the doctors, researchers and politicians, as well as the pharmaceutical companies, “vested interests” include billions of dollars spent marketing to doctors and interns each year. It is money-based medicine. In fact it’s more than $10 billion each year in the U.S. alone. The term “marketing” is perhaps a little loose because this spending involves sponsored holidays, retreats, conferences (all expenses paid), gifts—some non-taxed of course, like expensive bottles of wine—and the list goes on. The major medical journals recognise this now and call a medical professional who receives only $10,000 (U.S.) from a single pharmaceutical company “independent.” If you do a few bits of independent work for a few big companies, as long as you get only $10,000 from each one, it is considered acceptable. No other profession is allowed to do this.
It is usually not your general practitioner who receives the extra money, but the specialists and key figures in the area. It is a little scary when you recognise that the people who are outspoken on a health topic may be receiving some benefits from these big organizations, but even worse, no one can scrutinise their research because, as the medical journals recognise, the pharmaceutical industry has very deep pockets. I have written extensively on this in my book The Great Cholesterol Deception. An entire chapter of the book is devoted to researchers’ vested interests, another to doctors’ vested interests and another to the influence of the pharmaceutical industry.
After two decades as an editor of The New England Journal of Medicine, one of the most prestigious medical journals in the world, Marcia Angell wrote, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.” In 2008 she wrote, “Over the past two decades, the pharmaceutical industry has gained unprecedented control over the evaluation of its own products. Drug companies now finance most clinical research on prescription drugs, and there is mounting evidence that they often skew the research they sponsor to make their drugs look better and safer.”1 This is a person on the front lines of the best medical research in the world. Little wonder the rest of us lack confidence in the research.

1            Conflict of Interest Reporting by Authors Involved in Promotion of Off-Label Drug Use: An Analysis of Journal Disclosures.

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