After several prestigious medical journals recently published articles by authors who were later discovered to hold undisclosed financial interests in the products they wrote about, scandal is brewing in the medical community.
The prestigious Journal of the American Medical Association (JAMA) has apologized publicly for publishing two papers which did not mention possible conflicts of the authors.
At the time one paper was published, only two of its 13 authors had revealed to the journal's editors their significant financial ties to drug companies, even though most medical journals now require authors and reviewers of papers to describe any possible conflicts of interest.
Why should you care about this issue?
If you consult a doctor for help with a serious illness, wouldn't you want your doctor's advice and the research supporting it to be unbiased, with only your best interests in mind? Here's some background on what's behind these headlines.
Consumer-directed TV and magazine ads for prescription drugs have proliferated in the past decade but, believe it or not, that's just the tip of the drug marketing iceberg! Physicians are the target of about 90 percent of the advertising money (an estimated $21 billion a year) spent by the pharmaceutical industry.
Drug promotions to doctors take many forms: visits from pharmaceutical reps bringing information about their company's products, small gifts, meals, drug samples, and free medical education courses for which a company may even pay all travel expenses.
There's no doubt that research and product development by pharmaceutical companies and makers of medical devices have brought huge benefits to many people. At the same time, the companies that develop these products must realize enough profits from product sales to make their research investments worthwhile. Drug promotions can create subtle biases that lead individual physicians to prescribe a particular medication even when it is more expensive than another equally effective one.
Companies also provide research grants and consulting contracts to some professors at academic medical centers. The resulting research can lead to important new discoveries, but the doctors and researchers who receive the funds may have a financial conflict of interest that could lead them to overstate the value of a product when they report their research or review the research of others.
The Food and Drug Administration also has been criticized for allowing experts with pharmaceutical industry ties to serve on the scientific panels that advise the FDA on new drug approvals.
But these problems can't all be blamed on profit motives of the health industry. Physicians themselves must step up and address the issue of inappropriate ties to industry. Writing in JAMA, a group of prominent physician leaders has proposed that academic medical centers prohibit all company gifts, even the memo pads and coffee mugs, and stop accepting free meals and drug samples. These and other policy changes were recommended "to protect the best interests of patients and the integrity of physicians in decision making."
In the end, it's the quality of the health care advice you receive in the privacy of your doctor's office that's at stake.
