HOW MUCH do doctors who research new treatments for diseases benefit personally from drug company money? It's hard to know for sure. With government funding on the wane, money from pharmaceutical companies and medical device makers for research is unavoidable. The public at least deserves full and accurate disclosure of potential conflicts that accepting drug company consulting and speaking fees could pose. But recent congressional investigations give patients little reason for confidence.
According to these investigations, three child psychiatrists associated with Harvard Medical School and Massachusetts General Hospital have greatly underreported the fees they have been getting from drug companies. Staffers for Senator Charles Grassley, an Iowa Republican, believe the three might have violated federal and university conflict-of-interest rules. Both the medical school and the hospital have said they will review the disclosures made by Dr. Joseph Biederman, Dr. Timothy Wilens, and Dr. Thomas Spencer to see if they are adequate.
The three have said that they believe they have complied with the institutions' rules. The medical school and hospital have also said they will review their policies.
Full transparency is important for the public - and especially the doctors' fellow practitioners in the treatment of children - to judge study results by the doctors who report favorably on the use of antipsychotic drugs that are usually prescribed for adults and have serious side effects.
The National Institutes of Health has left the policing of disclosure rules to universities and hospitals. The allegations by Grassley's investigators, who got information from the drug companies themselves, including Eli Lilly, about payments to the doctors, provide evidence that research institutions have not been aggressive about verifying the information that doctors volunteer. Grassley has sponsored a bill that would require drug companies and medical device makers to report each year all payments to doctors of $500 or more.
While that would bring needed daylight to the fees the physicians get, a long-term solution to conflicts of interest is to increase the role of government funding in medical research. Better disclosure will tip off the public when an industry-funded doctor hails a new drug treatment for a mental illness, but will still leave unanswered the question of whether an entirely different form of therapy might in the end be better.