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How Drug Company Money Is Undermining Science

The pharmaceutical industry funnels money to prominent scientists who are doing research that affects its products–and nobody can stop it.

The entanglements between researchers and pharmaceutical companies take many forms. There are speakers bureaus: a drugmaker gives a researcher money to travel—often first class—to gigs around the country, where the researcher sometimes gives a company-written speech and presents company-drafted slides. There is ghostwriting: a pharmaceutical manufacturer has an article drafted and pays a scientist (the “guest author”) an honorarium to put his or her name on it and submit it to a peer-reviewed journal. And then there is consulting: a company hires a researcher to render advice. Researchers “think what these companies are after are their brains, but they’re really after the brand,” says Marcia Angell, former editor in chief of the New England Journal of Medicine. “To buy a distinguished, senior academic researcher, the kind of person who speaks at meetings, who writes textbooks, who writes journal articles—that’s worth 100,000 salespeople.”

Peer-reviewed journals are littered with studies showing how drug industry money is subtly undermining scientific objectivity. A 2009 study in Cancer showed that participants somehow survived longer when a study’s authors had conflicts of interest than when the authors were clean. A 1998 study in the New England Journal of Medicine found a “strong association” between researchers’ conclusions about the safety of calcium channel blockers, a class of drugs used to reduce blood pressure, and their financial relationships with the firms producing the drugs. It is not just an academic problem. Drugs are approved or rejected based on supposedly independent research. When a pill does not work as advertised and is withdrawn from the market or relabeled as dangerous, there is often a trail of biased research and cash to scientists. For example, in the mid-2000s, when patients started suing Wyeth about an estrogen drug, Prempro (which has been linked to the risk of breast cancer, strokes and certain other diseases), Wyeth’s ghostwriting/guest-authorship arrangements became a central part of the case. When it was the turn of Merck’s Vioxx painkiller (which was linked to heart attacks and strokes), drug industry money came up, too. In one Vioxx study, for example, academic researchers appear to have signed on to a Merck-sponsored project after the company had already done all the data analysis. According to a 2010 study that appeared in the British Medical Journal, 87 percent of researchers who expressed “favorable views” of GlaxoSmithKline’s diabetes drug Avandia, despite indications that it might increase the risk of heart attacks, had some financial involvement with the drug’s manufacturer. And when a U.S. Food and Drug Administration committee debated whether or not to pull Avandia from the market because of the link to heart attacks, it came out that members of the committee, too, had been taking money from drug companies.
The scientific community’s answer to the conflict-of-interest problem is transparency. Journals, grant-making institutions and professional organizations press researchers to openly declare—to their research subjects, their colleagues and anyone else affected by their work—when they have any entanglements that might compromise their objectivity. That way the scientific community decides whether a study is ethical and, when the experiment is done, how far to trust the results. It is an Honor System. Researchers often fail to report conflicts of interest—sometimes because they do not even realize that they present a problem

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In theory, there is a backup system. Several layers of checking are supposed to ensure that conflicts of interest are caught and exposed even when an oblivious or dishonest researcher does not report them. When a scientist fails to report such a conflict, the university or hospital he or she works for is supposed to spot it and report it. And when a university or hospital is not doing its job catching conflicted research, then the government agency that funds most of that research—the National Institutes of Health—is supposed to step in. Unfortunately, that backup system is badly broken. “Institutions often look the other way, or they have policies in place that are quite weak,” says Adriane Fugh-Berman, a professor in Georgetown University’s department of pharmacology and physiology.
More shockingly, the NIH is not only failing to enforce ethics laws intended to stop the creeping influence of drug company money, but it may also be breaking those laws.

Scientific American Dec. 1, 2012 By Charles Seife