Why must maintain an arm length relationship with the pharmaceutical industry

How Tightly Do Ties Between Doctor and Drug Company Bind?

I have blogged about this issue periodically over the past 2 years. We fool ourselves if we think that the pharmaceutical industry does not influence us. They do understand marketing!

Is the nice pen I accept from a drug company an implicit promise that I will prescribe the drug whose name is etched on its barrel, or is it just a pen? Does the grant money a researcher receives from a pharmaceutical company indicate that the research will be subtly prejudiced, or is it just money? And even when financial issues are not involved, what about all the other less tangible factors that may sway scientific judgments, from the philosophical convictions of interest groups to individual researchers’ determination to enhance their own reputations?

These questions have escalated in our time, experts say, because our society increasingly forces us to trust the expertise of professionals who are strangers to us.

“We are now much more dependent on the judgment of others, much less able to evaluate their judgment decision by decision, and indeed generally know much less about those individuals than we would have even 50 years ago,” wrote the philosopher Michael Davis in a 2001 book, “Conflict of Interest in the Professions.”

In medicine, the problem has been compounded by the increasing public distrust of the pharmaceutical companies, as controversy about drug pricing mounts. Meanwhile, the fraction of biomedical research sponsored by the pharmaceutical and other for-profit industries has soared, rising to 62 percent in 2000 from 32 percent in 1980, as government research support declines.

As medical research and business jostle ever closer, medical journals are devoting quantities of editorial commentary to the question of whether financial ties create partisan research and, if so, what to do about it.

The problem appears real. One study, published in 1998, examined dozens of articles about calcium-channel blockers, a controversial family of blood pressure medications that some doctors feel are dangerous for certain patients. Authors who championed the drugs’ safety proved far more likely to have financial relationships with the manufacturers than did the critics. A similar study linked authorship of articles discounting the dangers of passive smoking with financial ties to the tobacco industry.

To repeat my own personal ethics, I follow the $10 rule. I will eat lunch paid for by drug companies if the conference content is independently chosen. I will not go to dinner meetings. I will not go to social events. I will not buy pharmaceutical stocks. I will not meet with pharmaceutical reps.

I do not trust myself, because I know the data. They are trying to influence me, and I would rather gain my medical information without any bias.

Money is seductive. I see resident’s seduced by dinners at nice restaurants. I see researchers seduced by generous research funding. We must become aware that the seducer expects a return on investment.

The public rightly expects better of us.