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Healthy Skepticism Library item: 4190

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: Journal Article

Hillman AL, Eisenberg JM, Pauly MV, Bloom BS, Glick H, Kinosian B, Schwartz JS.
Avoiding bias in the conduct and reporting of cost-effectiveness research sponsored by pharmaceutical companies.
N Engl J Med 1991 May 9; 324:(19):1362-5


Abstract:

Because of the growing focus on containing health care costs, pharmaceutical companies are trying to demonstrate the cost effectiveness of their products relative to alternatives. This article explores the conduct of industry-sponsored economic analysis and offers examples of some specific biases that may occur because of the behaviour of the investigator, the sponsoring company or both. It explores whether there is a role for regulation by the Food and Drug Administration and finally offers suggestions for structuring the relationship between industry and academia so that bias is minimized in economic analyses of pharmaceuticals.

Keywords:
*analysis/United States/drug company sponsored research/Food and Drug Administration/FDA/pharmacoeconomic analysis/relationship between medical profession and industry/publication bias/regulation of promotion/ATTITUDES REGARDING PROMOTION: INDUSTRY/INFORMATION FROM INDUSTRY: PHARMACOECONOMIC ANALYSIS/REGULATION, CODES, GUIDELINES: DIRECT GOVERNMENT REGULATION/SPONSORSHIP: RESEARCH Cost-Benefit Analysis* Drug Industry* Ethics, Professional Prejudice* Research/methods United States

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909