Is Industry-Funded Science Killing You? the Overrated Risks and Underrated Benefits of Pharmaceutical Research "Conflicts of Interest"
Bailey, Ronald, Reason
IN 2004 GLAXOSMITHKLINE became the first major drug manufacturer to publicly disclose all the data from clinical studies of its products, including information that is usually treated as a trade secret. It was responding to a lawsuit by Eliot Spitzer, then New York's attorney general and now its governor, who accused Glaxo of hiding data about the safety and efficacy of one of its drugs. Sure enough, the company had concealed data indicating its antidepressant Paxil increased the risk of adolescent suicide. More-recent research suggests that link might not exist after all, but even if that proves true, it doesn't excuse the initial concealment.
A month later, Merck pulled its new pain reliever, Vioxx, off the market after clinical trial data showed that patients taking it had a 400 percent greater chance of heart attack than those taking the comparison drug, naproxen. Merck researchers implausibly argued that the difference was due not to damage caused by Vioxx but to the other drug's cardio-protective properties. No previous research had found that naproxen protects the heart.
For critics of the pharmaceutical industry, the Vioxx and Paxil incidents are evidence that conflicts of interest have thoroughly corrupted American medical research. "The Vioxx withdrawal serves as a reminder of the dangerous potential for conflict of interest that exists when pharmaceutical and other for-profit businesses control the dissemination of findings generated by medical research" warned a November 2004 editorial in the Dayton Daily News. In March 2005, the left-leaning Center for Science in the Public Interest (CSPI) pointed out that a Food and Drug Administration (FDA) panel that reviewed data on the risks posed by COX-2 painkillers like Vioxx included 10 researchers with financial ties to the companies that manufactured those drugs. Had the panelists with conflicts been excluded, a majority of the remaining members would have voted against approving Vioxx for distribution.
The Paxil incident prompted a June 2004 statement from the New York Attorney General's Office warning that "the ability of drug companies to pick and choose the research they provide doctors in support of their product is an outrageous conflict of interest and puts us all in harm's way." An August 2005 story about industry-funded medical research in the San Jose Mercury News quoted Sheldon Krimsky, a longtime critic of pharmaceutical companies, who asserted that "the entire system of drug testing is filled with conflicts of interest."
There's no question that some companies have behaved badly in some cases. But are these cases typical or rare?
Activists, politicians, and other critics claim conflicts of interest are pervasive in pharmaceutical research. Several years ago CSPI established an Integrity in Science Project to investigate and publicize the destructive influence of industry-sponsored science. Not to be outdone, the Union of Concerned Scientists launched its own Scientific Integrity Program to "push for reforms that will protect our health, safety, and environment."
Politicians are jumping on the bandwagon, proposing more-stringent regulations of private clinical research. Sens. Christopher Dodd (D-Conn.) and Edward Kennedy (D-Mass.) recently introduced the Fair Access to Clinical Trials Act, which would require all clinical trials to be registered in a central government database. Marcia Angell, a senior lecturer in social medicine at Harvard University, wants to ban privately funded clinical trials altogether. Instead, she proposes that drug companies be forced to pay into a government fund that would finance a new National Institute of Prescription Drug Trials to conduct all future clinical testing.
Supporters of such changes argue that conflicts of interest undermine public trust in and support for scientific research, endanger research subjects and patients, and boost medical costs by encouraging physicians and patients to use new treatments that are no better than cheaper alternatives. …