As The FTC Goes After Bloggers, Doctors Making Millions Promoting Drugs With Little Oversight

from the feeling-healthy-yet? dept

Clay Shirky points us to a column from a few months back by Marcia Angell, which explains why clinical research on drugs isn't even remotely trustworthy, as it all-too-often seems to involve doctors who have serious conflicts:
Or consider Dr. Alan F. Schatzberg, chair of Stanford's psychiatry department and president-elect of the American Psychiatric Association. Senator Grassley found that Schatzberg controlled more than $6 million worth of stock in Corcept Therapeutics, a company he cofounded that is testing mifepristone--the abortion drug otherwise known as RU-486--as a treatment for psychotic depression. At the same time, Schatzberg was the principal investigator on a National Institute of Mental Health grant that included research on mifepristone for this use and he was coauthor of three papers on the subject.
Angell notes that this is pretty common:
Indeed, most doctors take money or gifts from drug companies in one way or another. Many are paid consultants, speakers at company-sponsored meetings, ghost-authors of papers written by drug companies or their agents, and ostensible "researchers" whose contribution often consists merely of putting their patients on a drug and transmitting some token information to the company.
And as the relationship between doctors and pharma has gotten deeper and deeper, it means that the results of those all important "clinical trials" -- which the pharma supporters always insist are so important -- are highly suspect:
Because drug companies insist as a condition of providing funding that they be intimately involved in all aspects of the research they sponsor, they can easily introduce bias in order to make their drugs look better and safer than they are. Before the 1980s, they generally gave faculty investigators total responsibility for the conduct of the work, but now company employees or their agents often design the studies, perform the analysis, write the papers, and decide whether and in what form to publish the results. Sometimes the medical faculty who serve as investigators are little more than hired hands, supplying patients and collecting data according to instructions from the company.

In view of this control and the conflicts of interest that permeate the enterprise, it is not surprising that industry-sponsored trials published in medical journals consistently favor sponsors' drugs--largely because negative results are not published, positive results are repeatedly published in slightly different forms, and a positive spin is put on even negative results. A review of seventy-four clinical trials of antidepressants, for example, found that thirty-seven of thirty-eight positive studies were published. But of the thirty-six negative studies, thirty-three were either not published or published in a form that conveyed a positive outcome. It is not unusual for a published paper to shift the focus from the drug's intended effect to a secondary effect that seems more favorable.
And yet the FTC is more worried about a mommy blogger recommending a book that a publisher sent her for free?
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Filed Under: conflicts, doctors, drugs, fda, ftc


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  1. identicon
    bigpicture, 21 Oct 2009 @ 10:14am

    New Concept

    Is this a new concept? Since the medical and legal professions started there has always been this "conflict of interest" issue, that is largely ignored in the USA. A doctor makes more money by keeping a patient ill, and a lawyer makes more money by advocating divorces, litigations etc. So then how does a patient get cured? How do people with disagreements get reasonable resolution?

    This after all is a personal integrity issue both for doctors, lawyers and society at large. Maintaining health begins with food, restoring health usually can be achieved with specific compounds. So the food industry needs to be investigated and properly regulated, the prescription drug industry needs to be investigated and properly regulated, the medical establishment needs to be investigated and properly regulated. As to whose interests they serve, the interests of general public health or the interests of profits. In ancient China you did not pay the doctor unless you got well, you did not pay for treatments. This concept exists in contract pay types today, where you pay for a deliverable. Pay only for delivered outputs and not inputs, and gets rid of the "I don't have to produce a result" conflict of interest.

    Look at the mess the good old USA in in now, because they are 20 years behind other developed countries in asking these questions, and acting on them, so profit is still the driving force, and look at the results. All the parties of interest me, me, me, me. And as to lawyers, well who is going to investigate them, over 50% of politicians are usually ex lawyers.

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