Since pharmaceutical industry covers through advertising dollars the major cost of publication, they exert an influence over content. They support content that is in their financial interest, and oppose the opposite--jk
PLOS Medicine (a peer reviewed access journal at http://medicine.plosjournals.org)
Medical Journals Are an Extension of the Marketing
Arm of Pharmaceutical Companies
Richard Smith is Chief Executive
of UnitedHealth Europe, London, United Kingdom. E-mail: richardswsmith@yahoo.co.uk Competing Interests: RS was an editor for the BMJ
for 25 years. For the last 13 of those years, he was the editor and chief executive of the BMJ Publishing Group, responsible
for the profits of not only the BMJ but of the whole group, which published some 25 other journals. He stepped down
in July 2004. He is now a member of the board of the Public Library of Science, a position for which he is not paid. Published: May 17, 2005 DOI: 10.1371/journal.pmed.0020138 Copyright: © 2005 Richard Smith. This is an open-access
article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the original work is properly cited. Citation: Smith R (2005) Medical Journals Are an Extension
of the Marketing Arm of Pharmaceutical Companies. PLoS Med 2(5): e138 |
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The Orange County Register, Health & Science Section, Weds., Oct. 20, 1999, p. 20. In drug studies, money
counts
FUNDING: Drug-company sponsorship makes for less-critical views, researchers say. By DON BABWIN The Associated Press CHICAGO — Studies on the cost-effectiveness of drugs are far more likely to report
favorable findings if they are sponsored by the drug companies themselves rather than independent groups, researchers
found. Their study — funded by a pharmaceutical company — appears to confirm long-held
suspicions that doctors are less critical about a drug's safety and effectiveness when they have financial ties to the manufacturer. "It is possible that these factors may result in some unconscious bias"
in interpreting a study's findings, the researchers said. Last year, the conflict-of-interest issue made headlines when a report found
that the vast majority of doctors who defended the safety of calcium channel-blockers had a financial relationship with manufacturers
of the blood-pressure pills. In the current study, published in today's
Journal of the American Medical Association, the researchers looked at 44 studies on the cost-effectiveness of cancer
drugs. Twenty of the studies were funded by pharmaceutical companies and 24 by nonprofit organizations. Those
sponsored by nonprofit groups reached unfavorable conclusions 38 percent of the time, compared with just 5 percent for
studies sponsored by pharmaceutical companies. Also, researchers in company-backed studies were slightly more likely
to overstate the cost-effectiveness. Some researchers receive funding directly
from pharmaceutical companies. Some get funding in the form of honoraria or travel expenses. Some hold stock in
drug companies and profit directly from increased drug sales. Dr. Charles Bennett, the lead author and a professor at Northwestern Medical School,
said that in addition to the possibility
of unconscious bias, there could be other explanations for the findings.
For example, pharmaceutical
companies are given early looks at studies. That enables them to abandon studies that appear to be unfavorable and focus on
those they think are going to be positive, Bennett said. Bennett said the findings
should not be seen as a major criticism of pharmaceutical companies. "Our study
was sponsored by a pharmaceutical company," he said, adding that the company, Amgen Inc., did not comment on it before
publication. He also said his paper analyzed studies sponsored by Amgen, which fared no better than other company-sponsored
studies. Bennett said the best thing would not be to stop pharmaceutical
companies fr6m sponsoring research, but to get other types of sponsors to underwrite studies, too, such as
managed-care organizations. Amgen spokesman David Kaye said: "If you want the best physicians in the world,
you have to let them run the trials.
If you kill a study or over-control it, word gets out and the best investigators won't do your studies." Others not involved with the study said the findings raise serious concerns. "The best hypothesis I can tell for that is the person doing the research has internalized
the values of their funder," said Sheldon Krimsky, a Tufts University professor who studies scientific integrity and
conflict of interest and who wrote an editorial about the study in JAMA. Dr.
Sidney Wolfe, director of Public Citizen's Health Research Group in Washington, agreed: "As in other studies of the drug
industry, this shows the financial interests of the drug industry rides over the actual data." Jk--Comments on the 1992 legislation affecting the FDA, which required the drug companies to contribute
to most of the cost for the approval of new drugs and which was followed by budget reductions of the FDA so that it couldn’t
fund follow-up studies on safety and efficacy of approved drugs. These legislative changes were lobbied for by the drug industry. The second is to further weaken the position of the smaller companies by adding an
additional expense which thereby forced them to be even more dependent upon the drug giants in raising the funds for the trials
and now also for FDA approval. How do you get honest reliable data: 1). Have the drug companies contribute
to a research pool, much like the way the State & Federal government contribute to the universities in a state to do other
types of research. Then let the university departments and the Graduate Study
Department work out how those funds are to be allocated. 2). Drug companies could still do basic
research, but the clinical trials would be run by the universities. 3). Those drugs developed by the universities
could then manufactured at a cost plus formulation, with the profits therefrom flowing back into the general pool. 1a). Permit the university departments
to funnel research into drugs into those area where the needs are greatest, such as where there is a lack of effective treatment,
the lost to society is greater, and where it seems that an effective medication would be sufficiently likely to be produced
in relatively short period of time. They would be less likely to fund research
on a me-to type of knockoff drugs which now make up over 90% of the drugs approved by the FDA.
2 & 3). This would result in a much
smaller role of the Pharmaceutical industry. The benefits of this would be lower
prices for drugs, a competitive advantage over foreign companies by lower pricing, and increased effort to develop drugs based
on needs rather than profits. Moreover, there would be more funds for research,
because universities are not so market driven as the pharmaceutical industry which squanders 75% of its profits on advertising
and while budgeting just 25% for research. |