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Healthy Skepticism Library item: 6852

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

Friedberg M, Saffran B, Stinson TJ, Nelson W, Bennett CL.
Evaluation of conflict of interest in economic analyses of new drugs used in oncology.
JAMA 1999 Oct 20; 282:(15):1453-7
http://jama.ama-assn.org/cgi/content/full/282/15/1453


Abstract:

Context  Recent studies have found that when investigators have financial relationships with pharmaceutical or product manufacturers, they are less likely to criticize the safety or efficacy of these agents. The effects of health economics research on pharmaceutical company revenue make drug investigations potentially vulnerable to this bias. Objective  To determine whether there is an association between pharmaceutical industry sponsorship and economic assessment of oncology drugs. Design  MEDLINE and HealthSTAR databases (1988-1998) were searched for original English-language research articles of cost or cost-effectiveness analyses of 6 oncology drugs in 3 new drug categories (hematopoietic colony-stimulating factors, serotonin antagonist antiemetics, and taxanes), yielding 44 eligible articles. Two investigators independently abstracted each article based on specific criteria. Main Outcome Measure  Relationships between funding source and (1) qualitative cost assessment (favorable, neutral, or unfavorable) and (2) qualitative conclusions that overstated quantitative results. Results  Pharmaceutical company–sponsored studies were less likely than nonprofit-sponsored studies to report unfavorable qualitative conclusions (1/20 [5%] vs 9/24 [38%]; P=.04), whereas overstatements of quantitative results were not significantly different in pharmaceutical company–sponsored (6/20 [30%]) vs nonprofit-sponsored (3/24 [13%]) studies (P=.26). Conclusions  Although we did not identify bias in individual studies, these findings indicate that pharmaceutical company sponsorship of economic analyses is associated with reduced likelihood of reporting unfavorable results.

Keywords:
*systematic review/oncology/drug company sponsored research/pharmacoeconomic analysis/reporting of results/ETHICAL ISSUES IN PROMOTION: LINKS BETWEEN HEALTH PROFESSIONALS AND INDUSTRY/SPONSORSHIP: RESEARCH Biomedical Research* Clinical Trials*/economics Conflict of Interest* Cost-Benefit Analysis Disclosure Drug Industry/economics* Drug Utilization/economics Drugs, Investigational/economics* Economics, Pharmaceutical/standards Medical Oncology/economics* Medical Oncology/standards Organizations, Nonprofit/economics* Publication Bias Research Support* Research Support, Non-U.S. Gov't Treatment Outcome United States

 

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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963