Scandals have eroded US public's confidence in drug industry.

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http://bmj.bmjjournals.com/cgi/content/full/329/7460/247

 

BMJ 2004;329:247 (31 July),

doi:10.1136/bmj.329.7460.247

 

Scandals have eroded US public's confidence in drug

industry

Jeanne Lenzer

 

New York

 

Only 13% of Americans believe that pharmaceutical

companies are " generally honest and trustworthy, "

putting the industry on a par with tobacco, oil, and

managed care companies, a recent Harris Poll survey

has found. Public confidence in drug companies has

plunged harder and faster than for any other industry,

the survey indicates (17 July, p 128).

 

The distrust appears to be spreading to respected US

medical bodies and academic journals in the wake of a

spate of public controversies concerning the influence

of drug companies.

 

Guidelines for lowering cholesterol concentrations,

issued on 12 July by the National Heart, Lung, and

Blood Institute and the American Heart Association,

sparked a furore when it was shown that all but one of

the nine authors had financial ties to the

manufacturers of cholesterol lowering drugs. The

institute subsequently posted on its website the

financial interests of all those involved.

 

Dr Barbara Alving, acting director at the institute,

said that the guideline panel members had been chosen

because of their " stature and track record in the

field and their integrity. " The guidelines were vetted

by the American Heart Association and 90 other

reviewers, she said, adding that leading medical

experts " are also often the very people whose advice

is sought by industry. "

 

But Dr Henry Barry, senior associate chairman of the

department of family practice at Michigan State

University, said: " Basically what we have are

[panellists] who are extrapolating data beyond what

was in the studies. And when you have folks who have a

financial interest, the question is, was that

extrapolation influenced by their financial

interests? "

 

Dr Michael Jacobson, executive director of the Center

for Science in the Public Interest, said the failure

to disclose the eight authors' competing interests in

the press release and the published paper was " a

travesty. " He added: " I don't question the science,

but this makes a mockery of disclosure rules. "

 

The scandal comes after the publication of a study

from the centre showing that the authors of 13 of 163

articles published in leading US medical journals had

failed to disclose " relevant conflicts of interest. "

 

One of the authors of a study on the sources of lead

in children living near a smelter failed to

acknowledge that her husband owned the smelter in

question.

 

Hidden competing interests are probably worse than the

centre's study indicated, said Dr Jacobson. " We used a

very narrow definition of conflicts and we only looked

at the first and last authors. In addition, we didn't

have access to the authors' documents, " he said.

 

A congressional hearing into drug companies'

concealment of negative data about antidepressants for

children may also have fallen foul of drug company

influence. Scheduled for 20 July, it was cancelled the

day before the subcommittee's chairman, Congressman

James Greenwood of Pennsylvania, became president of

BIO, the largest trade organisation for

biopharmaceutical companies.

 

Congressman Greenwood declined to respond to media

inquiries about his resignation, but his office did

say it believed the congressional hearings would be

rescheduled.

 

Dr Allen Goldhammer, the associate vice president for

regulatory affairs at Pharmaceutical Research and

Manufacturers of America, said, " I think we need to

define what influence means. " He added, " Data from

studies [are] audited and evaluated and go to the

[Food and Drug Administration] for review. [it] has

very stringent guidelines and doesn't let any of its

employees have any financial interests in the

industries they regulate. I don't think we should call

that influence. "

 

But the Food and Drug Administration's credibility has

come under fire recently for its cosy relations with

industry and its possible involvement in suppressing

negative data about antidepressants in children (24

July, p 189).

 

Congress has failed to exert " constructive oversight "

of the agency, said Dr Sidney Wolfe of the campaign

group Public Citizen. This failure could be related to

the large contributions many members of Congress

receive from drug companies, he said.