Medical Establishment in the Pockets of the Pharmaceuticals

Is Academic Medicine for Sale?

An editorial from the New England Journal of Medicine from 2000,
even more relevant today.

This woman is part of the system and therefore her conclusions are not nearly forceful enough. Those doctors in the employ of pharmaceuticals who have published (in this journal and all other "respectable" ones) are not mentioned by name, to disqualify their "findings". And since 2000 they continue to publish their slanted research. What's worse, their colleaugues continue to be recruited in greater numbers by the drug industry.

In 1984 the Journal became the first of the major medical journals to require authors of original research articles to disclose any financial ties with companies that make products discussed in papers submitted to us. (1) We were aware that such ties were becoming fairly common, and we thought it reasonable to disclose them to readers. Although we came to this issue early, no one could have foreseen at the time just how ubiquitous and manifold such financial associations would become. The article by Keller et al. (2) in this issue of the Journal provides a striking example. The authors' ties with companies that make antidepressant drugs were so extensive that it would have used too much space to disclose them fully in the Journal. We decided merely to summarize them and to provide the details on our Web site.

Finding an editorialist to write about the article presented another problem. Our conflict-of-interest policy for editorialists, established in 1990, (3) is stricter than that for authors of original research papers. Since editorialists do not provide data, but instead selectively review the literature and offer their judgments, we require that they have no important financial ties to companies that make products related to the issues they discuss. We do not believe disclosure is enough to deal with the problem of possible bias. This policy is analogous to the requirement that judges recuse themselves from hearing cases if they have financial ties to a litigant. Just as a judge's disclosure would not be sufficiently reassuring to the other side in a court case, so we believe that a policy of caveat emptor is not enough for readers who depend on the opinion of editorialists.

But as we spoke with research psychiatrists about writing an editorial on the treatment of depression, we found very few who did not have financial ties to drug companies that make antidepressants.

(Read rest here).