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Healthy Skepticism Library item: 19659

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: Electronic Source

Ornstein C
Should you care about those conflicts of interest?
Healthy Buzz 2011 Oct 14
http://cornstein.tumblr.com/post/11448311210/should-you-care-about-those-conflicts-of-interest


Full text:

Conflicts of interest between doctors and the pharmaceutical/medical device industry have been the subject of reams of stories, including many in our Dollars for Docs series.

Add two important ones this week. The first, from Cardiobrief, talks about the rampant ties between members of the National Lipid Association’s guideline writing panels and the companies who stand to benefit from the guidelines. Larry Husten writes:

Panel members, along with the NLA itself, have a dizzying number of industry relationships. The chair of the panel, Michael Davidson, “has received research grants from Abbott Laboratories, Daiichi Sankyo, GlaxoSmithKline, Merck & Co. and Roche… has received consulting fees from Abbott Laboratories, Aegerion Pharmaceuticals, Amgen, AstraZeneca, Atherotech Inc., Daiichi Sankyo, DTC MD, Esperion, GlaxoSmithKline, Intelligent Medical Decisions, Kinemed, LipoScience, Merck & Co, Novo Nordisk, Roche, Sanofi-Aventis, Synarc, Takeda Pharmaceuticals, and Vindico Medical Education…. has received honoraria related to speaking from Abbott Laboratories, GlaxoSmithKline and Merck & Co…. [and] has served on the Board of Directors of DTC MD, Omthera, Professional Evaluation Inc., and Sonogene.”
Also, this week, the British Medical Journal has a study about conflicts of interest on guideline writing panels for diabetes and hyperlipidemia. The results:

Fourteen guidelines met our search criteria, of which five had no accompanying declaration of conflicts of interest by panel members. 288 panel members had participated in the guideline development process. Among the 288 panel members, 138 (48%) reported conflicts of interest at the time of the publication of the guideline and 150 (52%) either stated that they had no such conflicts or did not have an opportunity to declare any. Among 73 panellists who formally declared no conflicts, 8 (11%) were found to have one or more. Twelve of the 14 guideline panels evaluated identified chairs, among whom six had financial conflicts of interest. Overall, 150 (52%) panel members had conflicts, of which 138 were declared and 12 were undeclared.
Here’s a couple of our stories that address this topic:

Financial Ties Bind Medical Societies to Drug and Device Makers

Emails Show Drug Company Used Third-Party Medical Groups to Influence Regulators, Undercut Rivals (By Marian Wang)

Cardiac Society Draws Bulk of Funding From Stent Makers

Is this much ado about nothing? Pushing back, the American Heart Association issued a release this week saying, in part:

We feel the suggestion that individuals with relationships with industry should be completely eliminated from all guidelines writing panels is not constructive because these individuals can provide relevant and informed input on the recommendations unrelated to their industry relationship. The association believes that our policies control the potential for inappropriate bias to influence guidelines development.
It’s impossible to know that a relationship with industry will in fact cause bias. We should not, for example, assume that those without financial ties to industry might not have other conflicts of interest.
What do you think? Do these conflicts concern you?

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963