Healthy Skepticism Library item: 20519

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Sweet M
New fears on doctors' links to drug firms
The Sydney Morning Herald 1998 Jan 233

Full text:

Doctors’ financial relationships with drug companies may have influenced a recent heated medical debate on the safety of a widely used class of blood pressure drug, a new study suggests.

The findings, described yesterday be a senior National Health and Medical Research Council (NHMRC) member as “very disturbing”, raise broad questions about the close links between the medical profession and the pharmaceutical industry.

They also have implications for medical journals, as only two out of 70 articles analysed in the study disclosed authors’ potential conflicts of interest.

The NHMRC’s Australian Health Ethics Committee will consider the findings as part of a review of its ethical code of practice for human experimentation.

The committee’s chairman, Professor Donald Chalmers, said one option could be to require researchers to disclose any potential conflicts of interest to patients participating in trials.

The study, reported recently in The New England Journal of Medicine, identified 70 articles, including studies, reviews and letters, published at the height of a controversy about the safety of calcium channel antagonists.

Authors who had been supportive of the drugs were more than twice as likely as critical authors to have financial ties to manufacturers of these drugs.

The Canadian researchers found that 96 per cent of the supportive authors had financial relationships with manufacturers such as receiving funds for research, attending conferences, or for educational programs.

Sixty per cent of the neutral authors had such relationships, as did 37 per cent of the critical authors.

About 8 million prescriptions for calcium channel antagonists are dispensed in Australia each year.

The Canadian study does not prove financial considerations influenced the doctors’ views; another possibility is that companies were more likely to approach and fund doctors who had published views sympathetic to their products.

But the director of the Medical Lobby for Appropriate Marketing, Dr Peter Mansfield, said the study was one of the best so far showing the potential for conflicts of interest which could bias health care.

Dr Ken Harvey, a senior lecturer in public health at La Trobe university, said it was too easy for doctors to “get into a slippery slope” of dependence on drug companies.

“It is very easy to start off from what is a proper relationship with industry in which one is doing appropriate clinical trials and then to become more and more dependent on that as a source of income”, he said.

“Unconsciously that dependence may lead to bias and perhaps a lack of clinical appraisal and at worst, in a few people, it leads to prostitution of their original scientific endeavours”.

Ms Libby Roughead, a University of South Australia researcher, said that finding that almost two-thirds of all authors had financial links with the industry was “alarming”, and urged consumers, doctors and journals to be more aware of the influence of such ties.