Healthy Skepticism Library item: 15438

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Publication type: news

Rabin RC.
Doctors Urge End to Corporate Ties
The New York Times 2009 Apr 1
http://www.nytimes.com/2009/04/02/health/policy/02journal.html?_r=1

Full text:

A group of prominent physicians and researchers on Wednesday urged professional medical groups to “wean” themselves from industry support and move toward a complete ban on corporate money for things like souvenir pens, tote bags and the sponsorships of committees that develop clinically important guidelines and training programs.

The recommendations are not binding and would have to be put in place by individual professional associations. Still, concern over industry support has been increasing among scientists, and several leading academic medical centers already are putting stringent policies in place.

In a paper in the April 1 issue of The Journal of the American Medical Association, the doctors’ group recommends that medical professional associations adopt stricter conflict-of-interest guidelines, not simply requiring the disclosure of financial ties to drug and medical device companies but also barring members with financial ties from serving in leadership positions and on certain influential committees within the association.

The authors are particularly adamant that professional medical associations should neither accept corporate money to underwrite the development of practice guidelines nor allow members with financial ties to industry to serve on committees that develop the guidelines, which are usually widely adopted as the gold standard for medical practice.

The authors acknowledged that while it would be difficult, even painful, to carry out the reforms, they were essential if physician associations are to maintain their scientific integrity and the trust of their patients.

“When we write a practice guideline, we are telling our colleagues how they should care for their patients,” said Dr. Steven E. Nissen, one of the authors of the paper and a past president of the American College of Cardiology, who supports what he calls a “zero dollar” policy, under which medical associations would not take any money from industry. “If you are one of those patients, you are counting on that guideline to be of the highest caliber, free of any influence.”

The recommendations would allow corporate sponsors to buy advertisements in medical journals and booths in halls adjacent to medical conferences.

“The consensus here was quite clear: You do not want the piper calling the tune,” said David J. Rothman, a professor of social medicine at Columbia University. “We ask that these groups make every effort to get to zero percent and, knowing that it is very difficult to do that, that they move as rapidly as possible to no more than 25 percent,” referring to how much of their support should come from industry.

Marjorie Powell, senior assistant general counsel for Pharmaceutical Research and Manufacturers of America, a drug industry trade group, said the proposals could deprive the medical community of the expertise of some of its most experienced doctors, who are often deeply involved in industry-financed research.

“The vast majority of the research is funded by pharmaceutical companies,” Ms. Powell said. Important decisions regarding practice guidelines might be made, she said, by “very junior people who have no experience.”