Healthy Skepticism Library item: 16883
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Publication type: news
Berkovic N
ADHD panel's drugs links being properly `managed'
The Australian 2009 Nov 25
http://www.theaustralian.com.au/news/adhd-panels-drugs-links-being-properly-managed/story-e6frg6n6-1225803464651
Full text:
THE body charged with setting new guidelines for the treatment of ADHD has refused to release details of payments by drug companies to its experts, but has said conflicts of interest are being properly “managed”.
`The comment by the Royal Australasian College of Physicians comes after health experts this week called on federal Health Minister Nicola Roxon to appoint a new panel to draft ADHD treatment guidelines that was free of conflicts of interest.
Ms Roxon yesterday brushed aside criticism of the panel as well as concerns that its draft ADHD guidelines had been tainted by drug company payments to a US expert.
Instead, she said she expected new ADHD treatment guidelines would be released in the “very near future”.
There are currently no Australian guidelines for the treatment of ADHD, despite more than 400,000 prescriptions being written for ADHD medication every year.
The former guidelines, written in 1997, were scrapped four years ago as new drugs and research had become available.
Ms Roxon said she shared public concerns about the delay in the release of the guidelines.
“I expect that the draft guidelines . . . could be released in the very near future,” she said.
“The government is committed to the development of clear, evidence-based guidelines on the appropriate management of this condition.”
However, the new draft guidelines are under a cloud because of concerns that US research relied upon to draft them was compromised by drug company funding.
US-based child psychiatrist Joseph Biederman, a world-renowned authority on ADHD, is under investigation for failing to disclose much of $US1.6 million he received from drug companies between 2000 and 2007.
Dr Biederman has been credited with helping to fuel a worldwide spike in the use of anti-psychotic medicines in children.
His research is cited in the draft Australian guidelines more than 50 times. Chairman of the RACP’s guidelines working group, David Forbes, said the panel would not scrap its guidelines and start again.
“At this point, the evidence base has not changed sufficiently to warrant starting this process again,” Professor Forbes said.
Professor Forbes also defended the 10 experts on the panel, seven of whom have been linked to the ADHD industry.
“The members have declared conflicts of interest, and where these have been present, they have been managed according to the guidelines of the RACP and the National Health and Medical Research Council,” he said.
Monash University child psychiatry expert George Halasz said more scrutiny was needed of this panel’s links to the drugs industry, as well as the panel that drafted the original 1997 guidelines because there was a risk of “systemic dysfunction”.
“Clearly there are question marks about bias and conflicts of interest,” he said.
“There is no dominant theory about what ADHD is.
“When there’s no dominant theory you have to ask why there are people who insist on declaring the case is closed, when it’s just false.”
More than 400,000 prescriptions are written each year for ADHD medicines in Australia, which are part of the Pharmaceutical Benefits Scheme.
In 2007, about 60,000 patients were on ADHD drugs.
