latest admission by alopathic medicine.

[Guest guest]

" To return to our first question: how tainted by commercial conflicts

has

medicine become? Heavily, and damagingly so, is the answer. "

 

This is the conclusion of the Lancet article below. Next is the

commentary by

Vera Sharav on the article. We owe a big THANK YOU to Dr. Marcia

Angel past

editior of the New England Journal of Medicine who took the first

initiative

to begin this major house cleaning project in American medicine.

 

Dr. Tracy

 

ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)

www.researchprotection.org

 

Contact: Vera Hassner Sharav

Tel: 212-595-8974 FAX: 212-595-9086

veracare

 

FYI

 

The prestigious British journal, the Lancet, reports that " Total

retail

spending on prescription drugs was US $155 billion in 2001, almost

double

what it was in 1997. "

 

The escalating corrosive influence of big pharmaceutical companies in

medicine is bankrupting healthcare budgets and undermining the

integrity of

medical research institutions. Lancet reports that " supposedly

independent

medical journals " have been caught in publishing biased articles.

 

For example, the Journal of American Medical Association reported in

February that 90% of authors of clinical practice guidelines received

research funding from or acted as consultants for a drug company.

 

And, Lancet reports, the editor of the British Journal of Psychiatry

was a

member of a drug-company sponsored " educational organization " , for

which he

received £2000 annually. The editor published a favorable review of

the drug

manufactured by that company.

 

" Only after receiving the letter questioning his behaviour did

the editor change his journal's procedure, excluding himself from

decisions

about work sponsored by that same company. "

 

Industry's ubiquitous influence has corrupted the integrity of medical

research and the scientific literature upon which scientific research

is

built. Indeed, research on human subjects cannot ethically be

conducted

without a trustworthy body of scientific knowledge. [see, The

Nuremberg

Code, The Declaration of Helsinki, and the Belmont Report]

 

Industry may have delivered a fatal blow to a laudable enterprise:

the bias

that industry has injected effectively demolished the foundation upon

which

public and professional trust had been built.

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

www.thelancet.com

 

Lancet

Volume 359, Number 9313 06 April 2002

 

Editorial

 

JUST HOW TAINTED HAS MEDICINE BECOME?

 

 

Chief executives of multinational pharmaceutical companies have much

to

celebrate this week. They saw spending on prescription drugs in the

USA soar

by a remarkable 17% in 2001, according to figures recently released

by the

National Institute for Health Care Management Foundation. As bonuses

for

corporate leaders ratchet upwards, so does the unalleviated financial

pressure on the elderly, the largest users of these drugs.

 

Direct-to-consumer advertising campaigns for cholesterol-lowering

agents,

anti-ulcer medications, anti-arthritics, and antidepressants have been

strikingly successful. Total retail spending on prescription drugs was

US$155 billion in 2001, almost double what it was in 1997.

 

The escalating influence of big pharma in medicine persuaded editors

of

medical journals to come together last year and agree strict rules on

reporting sponsorship and conflicts of interest (see Lancet 2001; 358:

854-56). While this consensus sets the highest standards yet for

disclosing

commercial influences in medical research, there are signs that it

does not

go far enough--or, at the very least, that this guidance is not being

fully

heeded.

 

A study of the interactions between authors of clinical practice

guidelines

and the pharmaceutical industry, published in JAMA in February, found

serious omissions in declarations of conflicts of interest. Almost

90% of

authors received research funding from or acted as consultants for a

drug

company. Over half had connections with companies whose drugs were

being

reviewed in the guideline, and the same proportion indicated that

there was

no formal procedure for reporting these interactions. The guidelines

studied

covered all fields where prescription drug use has seen the greatest

increases.

 

An especially corrosive example of such a commercial influence,

involving

one of the most respected US specialist societies--the American Heart

Association--was described in the BMJ last month. Was the AHA

sensible to

accept US$11 million in donations from Genentech while at the same

time

producing guidelines about thrombolytics in stroke? Genentech is the

US

producer of one such thrombolytic, which was recommended for use in

the AHA

2000 guidance on stroke management.

 

Prestigious institutions are also not averse from mixing research with

commercial gain from industry partnerships. The Seattle Times has

conducted

one of the most thorough investigations of how such relations

threaten to

poison patient care. In a series of articles published last year,

staff

reporters Duff Wilson and David Heath claimed to reveal how

investigators at

the Fred Hutchinson Cancer Research Center completed experiments with

biotechnology products in which they had a direct financial interest.

The

journalists allege that doctors did not tell patients that others had

died

using these products and that there were safer alternatives

available. The

Center denies these allegations but admits that it " could have handled

better " perceptions of conflict of interest.

 

These concerns extend to journal editors, especially those who edit

part-time while continuing to work in clinical practice and research.

The

rules issued by the International Committee of Medical Journal

Editors state

that, " Editors who make final decisions about manuscripts must have no

personal, professional, or financial involvement in any of the issues

they

might judge " .

 

However, the editor of the British Journal of Psychiatry was

recently questioned about his membership of a drug-company sponsored

" educational organisation " , for which he received £2000 annually,

together

with his decision to publish a paper favouring a drug manufactured by

the

same company. Only after receiving the letter questioning his

behaviour did

the editor change his journal's procedure, excluding himself from

decisions

about work sponsored by that same company. He avoided the issue about

whether he should have any commercial liaisons while acting as editor

of a

supposedly independent medical journal.

 

The Lancet's policy is that editors should divest themselves of all

such

links upon assuming their new duties.

 

To return to our first question: how tainted by commercial conflicts

has

medicine become? Heavily, and damagingly so, is the answer. A more

important

question arises: do those doctors who support this culture for the

best of

intentions--eg, to undertake important research that would otherwise

remain

unfunded--have the courage to oppose practices that bring the whole of

medicine into disrepute?

The Lancet

www.thelancet.com