Undue influence of drug firms may find way into diagnoses

October 28, 2010

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PRESCRIPTION FOR prestige’’ (Page A1, Oct. 19) provides data that demonstrate the need for greater oversight of relationships between the pharmaceutical industry and the academic world. There is a clear conflict of interest when doctors can parlay their academic connections into hundreds of thousands of dollars to speak about a specific drug, especially when the company that manufactures the drug gets to decide what information is disseminated. But that’s just the tip of the iceberg.

Undue industry influence may be compromising the very guidelines that doctors rely on for diagnosing and treating patients. This is because of a legal, but controversial, practice that permits researchers with financial ties to pharmaceutical companies (such as those who participate on company speakers bureaus or who receive large research grants) to serve as experts on medical guideline-writing panels.

Industry is thus allowed to have a strong voice in determining the validity of new diagnoses (for example, “attenuated psychotic symptoms syndrome’’ and “premenstrual dysphoric disorder’’) and to make recommendations about what drugs should be used to treat these disorders.

Sometimes there is questionable evidence to support the validity of new disorders, and clinical drug trials frequently yield conflicting results about the effectiveness and safety of medications. Allowing individuals who currently have, or who recently had, financial ties to industry to have such decision-making power creates an opportunity for industry to corrupt science.

Lisa Cosgrove
The writer, an associate professor at University of Massachusetts Boston, is currently a fellow at the Edmond J. Safra Center for Ethics at Harvard University.

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