Group Targets Medical Industry's Influence

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Group Targets Medical Industry's Influence

 

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Tue Sep 28,12:48 PM ET

 

By DIEDTRA HENDERSON, AP Science Writer

 

WASHINGTON - Doctors who receive drug company funding would be limited

in what they could teach other physicians under new rules being

proposed by accreditors.

 

The Chicago-based Accreditation Council for Continuing Medical

Education, which gives its stamp of approval for such classes, was to

announce sweeping changes Tuesday to limit the influence of doctors

with financial connections to the pharmaceutical industry.

 

The nation's 750,000 physicians stay up to date on medical advances

through mandatory participation in thousands of continuing education

activities per year.

 

In the past, a doctor teaching such a course would disclose his or her

financial relationship with any drug company, say as a paid member of

the company's speakers' bureau or a grant recipient. Once that was out

in the open, the physician might then talk glowingly about anecdotal

experience with that company's drug.

 

Now, a third party with no ties to the drug company would have to tell

the doctor what kind of recommendations he or she could make.

Anecdotal observations would be replaced by results of systematic

clinical trials. Any review of journal literature would have to

include negative, as well as positive, studies.

 

" So this whole thing about just saying 'I've got a conflict of

interest. And I've got a relationship. And I've got a personal

opinion. And I'm probably biased. But, I'm going to tell you anyways,'

that's not allowed, " said Murray Kopelow, chief executive of the

accreditation council.

 

Doctors who balk at the new rules will be barred from presenting or

teaching at continuing medical education conferences.

 

The changes were endorsed by the council's seven members, including

the American Medical Association. Kopelow could not say how many

doctors would be affected.

 

Earlier this month federal advisers endorsed highly visible

" black-box " warning labels linking antidepressants to heightened

suicidal thoughts and actions among children. The vast majority of

American children who are prescribed antidepressants are taking drugs

that have never been proved to ease depression among youngsters.

 

Pharmaceutical companies are prohibited by law from promoting such

off-label use of the drugs. Doctors, however, have faced few similar

restrictions.

 

Dr. Norm Fost, a member of the Food and Drug Administration (news -

web sites)'s Pediatric Ethics Subcommittee, said many doctors are

learning about off-label prescriptions during continuing medical

education activities. He had no data, though, to support his hunch.

 

" In 23 studies, none of them has been shown to have any efficacy in

children, other than Prozac. And there's all this increasing noise

level about toxicity, " Fost said. " Why would physicians make millions

of prescriptions a year? Where would they get that idea?

 

" Usually, where they get it is from one of three sources. One:

pharmaceutical companies. Two: pharmaceutical companies. And three:

pharmaceutical companies. "

 

A Pharmaceutical Research and Manufacturers of America attorney

dismissed the notion of " stealth marketing " by drug companies.

 

" All of the PhRMA member companies know that if they are, in fact,

trying to influence the content of an individual speaker's

presentation, they're risking FDA (news - web sites) enforcement, "

said Marjorie Powell, PhRMA senior assistant general counsel. " All the

companies have to work with FDA all the time. "

One observer called the rule changes " enlightened and refreshing, " but

late.

 

" Wherever there is a competing financial interest, there is a

potential conflict. And wherever there is a potential conflict, you

ought to find somebody else to do the job, " said Bernard J. Carroll, a

semiretired psychiatrist who has lobbied for transparency. " Money

corrupts and lots of money corrupts absolutely. "

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