Another company in trouble

6 Jul
2005

Senators Ask Drug Giant to Explain Grants to Doctors

The Senate Finance Committee yesterday began an inquiry into whether Johnson & Johnson used educational grants to promote the pediatric use of its former heartburn medication, Propulsid, even as internal company concerns mounted during the 1990’s about the drug’s safety in some children.

The inquiry follows a June 10 article in The New York Times describing how, despite growing evidence linking the drug to heart problems and deaths, the company helped pay for a physician’s book recommending Propulsid’s use in children and gave grants to pediatric gastroenterology organizations that favored such use.

Johnson & Johnson withdrew Propulsid in 2000 after reports of 80 heart-related deaths and 341 injuries among patients taking the medication.

In a letter yesterday to the company’s chief executive, William C. Weldon, Senators Charles E. Grassley and Max Baucus cited the article and requested information and documents disclosing who received the grants, the amount of those grants and their purpose.

Mr. Grassley, an Iowa Republican who is the committee chairman, and Mr. Baucus, its senior Democrat, from Montana, said the committee had decided to expand an inquiry, begun June 9, into how pharmaceutical companies sometimes use physician education seminars and research grants to discuss using drugs to treat conditions beyond those approved by the Food and Drug Administration.

Such efforts can be legal under federal drug laws, but critics say the activities too often go beyond education and instead promote the off-label use of drugs.

I always have angst with these stories. The pharmaceutical industry develops important therapeutic tools. The drugs should sell themselves. However, in our society, we always try to influence purchases – regardless of the product. The problem that I struggle with is how to define ethical influence and separate it from unethical influence. I believe this case represents unethical influence. Developing a code to prevent such abuses is much more challenging than it first appears. We must be careful to only throw out the dish water.

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1 Response to Another company in trouble

Avatar

Rob Norton

July 7th, 2005 at 7:43 am

Nice post. These stories give me heartburn too. It is correct to say that development of a code to prevent abuse is complicated, but the industry needs to tighten up its grant processes or this important source of educational funding may be sharply curtailed. I posted some of obvious industry policy reforms on my blog. That said, some responsibility for the cleanup must be shared by the frequent beneficiaries of educational grants (physicians, academic institutions, hospitals). Grant requests, whether written or spoken, often come with a tacit, and sometimes not so tacit, commitment to assist promotion of off-label indications. This must end – physicians can help.

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