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Financial Ties Between Big Pharma and the Medical Establishment: 37 Selected Articles Published Between 2005 and 2008

Posted Sep 14 2008 10:15am

As I pointed out before ( “Is It Possible Some Doctors Still Don’t “Get” the Extent of Big Pharma’s Connection to ‘Standard of Care’ Research?” ), I believe that many physicians have somehow managed not to read the numerous articles exposing the financial connections between Big Pharma and the Medical Establishment. Many articles have appeared in medical journals, such as the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA); as well as in well-regarded lay publications, such as the Wall Street Journal, New York Times and Washington Post.

But somehow, many doctors seem not to have read them.

I believe that if more physicians had read these articles, they would not be so quick to rely on the “studies” financed by Big Pharma.

I have prepared the following list of 37 articles for doctors and patients to read. The articles attest to Big Pharma’s influence on the results of clinical trials, on the doctors/researchers who conduct the trials, and on the doctors who prescribe these medications to their patients. With each article, I have included a few paragraphs, and have bolded certain portions for emphasis. I have also included hyperlinks, so you and your doctor can read the entire articles.

The articles appear in chronological order. You may also access this list as a pdf file, so that you can share it with your doctors.

1) Not In My Name, The Guardian, Adriane Fugh-Berman, MD, April 21, 2005

Last summer, I was asked by RxComms, a British medical communication company, to author a review of interactions between herbs and warfarin (a generic anticoagulant prescribed to prevent strokes or blood clots). Well, not "author", exactly. The usual practice is for a complete article to be supplied; all I would have to do was review it and sign it off.

Months later, I received a completed, 2,848-word draft, with an abstract, references, and a table, ready for submission to a journal, with my name on it. A note asked me to return it with any changes within seven days.

I asked why AstraZeneca, sponsor of the article, was funding a manuscript that mentioned none of its products, and I was informed by RxComms that the paper was part of a series meant to highlight problems with warfarin - in particular, "warfarin's high interaction potential, which can give rise to problems with anticoagulation control". It seemed to me that the article was intended to help AstraZeneca lay the groundwork for a new drug, ximelagatran, to compete with warfarin.

2) The Corporate Coauthor, Society of General Internal Medicine, Adriane Fugh-Berman, MD, June 2005

Drug marketing techniques include the sponsorship of articles signed by academic physicians or researchers and submitted to peer-reviewed medical journals. Some of these articles are authored or coauthored by ghostwriters who work for pharmaceutical companies or medical education companies hired by pharmaceutical companies. Conflicts of interest may be difficult to detect in the subset of articles and presentations sponsored by pharmaceutical companies that never mention the targeted drug, but focus on stimulating the perceived need for the targeted drug or highlighting problems with competing drugs. The current voluntary standards for declaring conflicts of interest to readers of medical journals and audiences at medical conferences are inadequate. A public database that contains conflicts of interest of physicians and researchers would be useful.

3) The Effect of Conflict of Interest on Biomedical Research and Clinical Practice Guidelines: Can We Trust the Evidence in Evidence-Based Medicine? -- John Abramson, MD, MSFP and Barbara Starfield, MD, MPH, Journal of the American Board of Family Practice, September–October 2005 Vol. 18 No. 5

Approximately 75% of clinical trials published in The Lancet, the New England Journal of Medicine (NEJM), and the Journal of the American Medical Association (JAMA) are industry funded.

. . . .

. . . among even the highest quality clinical research (included in Cochrane reviews) the odds are 5.3 times greater that commercially funded studies will support their sponsors’ products than noncommercially funded studies.

. . . .

In this highly commercialized environment, how do we sustain the ideals that brought us to family medicine? We now know enough about the limitations of "evidence" to be much more cautious about what passes for it. Perhaps the family medicine journals, individually or in concert, could start sections of their journals for the specific purpose of critically reviewing the results of published trials.

. . . .

Finally, we family physicians have a professional responsibility to be less naive about the inherent divergence of our patients’ and the drug companies’ best interests. Our patients must come first.

4) Drug Profits Infect Medical Studies -- Los Angeles Times, by John Abramson, MD, January 7, 2006

Then the lead author of a seminal article published in the journal Science reporting the creation of viable stem cells from cloned human embryos admitted he falsified results and resigned his academic post in disgrace.

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