As I point out in “Is It Possible Some Doctors Still Don’t “Get” the Extent of Big Pharma’s Connection to ‘Standard of Care’ Research?”, I believe that somehow (although I am not sure exactly how) many physicians have managed not to read the hundreds, if not thousands, of articles in the press –- articles exposing the financial connections between Big Pharma and the Medical Establishment. So many of these articles have appeared in medical journals, such as the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA); and in well-regarded lay publications, such as the Wall Street Journal, New York Times, Washington Post and the Los Angeles Times.
Somehow, I am convinced that if more doctors had read these articles, they would not continue to rely so heavily on the results of studies that are published in their medical journals: results which tout the benefits of pharmaceuticals; results which are often financed by Big Pharma.
If they had read even a small number of these articles, they would know that 80% of the studies being reported on in their journals are funded and overseen by pharmaceutical companies, and that the journal articles themselves have often been written by Big Pharma employees.
They would know, as I have pointed out before, that those who conduct and write about these studies “cheat” in so many ways -- by:
• “Rigging” the so-called studies, which they themselves fund
• Hiding the results of the studies that actually prove their products don’t work, while -- at the same time
• Heavily publicizing the studies that demonstrate their products’ successes
• Hiring the researchers to conduct the studies, making it very clear to them exactly what kinds of results they are expecting the studies to show
• Hiring writers to write the articles that appear in the medical journals the doctors read
• Hiring big name doctors to affix their names to these studies, while doing very little, if any, of the writing.
37 ARTICLES THAT REVEAL BIG PHARMA’S DUPLICITY
I have prepared the following list of 37 articles for doctors and patients to read, and discuss together. These articles attest to Big Pharma’s influence on the results of clinical trials, on the doctors/researchers who conduct the trials, and on the doctors who prescribe these medications to their patients. With each article, I have included a few paragraphs, and have bolded certain portions for emphasis. I have also included hyperlinks, so you and your doctor can read the entire articles and talk about them.
The articles appear in chronological order. You may also access this list as a pdf file, so that you can share it with your doctors.
But before you continue reading this posting, I urge you to read this brief overview of the history of medical research -- which I have prepared and paraphrased from Dr. John Abramson’s excellent book, Overdosed America: The Broken Promise of American Medicine. It tells how medical research went from being almost 100% reliable to being up to 80% unreliable.)
THE 37 ARTICLES
1) Not In My Name, The Guardian, Adriane Fugh-Berman, MD, April 21, 2005
Last summer, I was asked by RxComms, a British medical communication company, to author a review of interactions between herbs and warfarin (a generic anticoagulant prescribed to prevent strokes or blood clots). Well, not "author", exactly. The usual practice is for a complete article to be supplied; all I would have to do was review it and sign it off.
Months later, I received a completed, 2,848-word draft, with an abstract, references, and a table, ready for submission to a journal, with my name on it. A note asked me to return it with any changes within seven days.
I asked why AstraZeneca, sponsor of the article, was funding a manuscript that mentioned none of its products, and I was informed by RxComms that the paper was part of a series meant to highlight problems with warfarin - in particular, "warfarin's high interaction potential, which can give rise to problems with anticoagulation control". It seemed to me that the article was intended to help AstraZeneca lay the groundwork for a new drug, ximelagatran, to compete with warfarin.
2) The Corporate Coauthor, Society of General Internal Medicine, Adriane Fugh-Berman, MD, June 2005
Drug marketing techniques include the sponsorship of articles signed by academic physicians or researchers and submitted to peer-reviewed medical journals. Some of these articles are authored or coauthored by ghostwriters who work for pharmaceutical companies or medical education companies hired by pharmaceutical companies. Conflicts of interest may be difficult to detect in the subset of articles and presentations sponsored by pharmaceutical companies that never mention the targeted drug, but focus on stimulating the perceived need for the targeted drug or highlighting problems with competing drugs. The current voluntary standards for declaring conflicts of interest to readers of medical journals and audiences at medical conferences are inadequate. A public database that contains conflicts of interest of physicians and researchers would be useful.
3) The Effect of Conflict of Interest on Biomedical Research and Clinical Practice Guidelines: Can We Trust the Evidence in Evidence-Based Medicine? -- John Abramson, MD, MSFP and Barbara Starfield, MD, MPH, Journal of the American Board of Family Practice, September–October 2005 Vol. 18 No. 5
Approximately 75% of clinical trials published in The Lancet, the New England Journal of Medicine (NEJM), and the Journal of the American Medical Association (JAMA) are industry funded.
. . . .
. . . among even the highest quality clinical research (included in Cochrane reviews) the odds are 5.3 times greater that commercially funded studies will support their sponsors’ products than noncommercially funded studies.
. . . .
In this highly commercialized environment, how do we sustain the ideals that brought us to family medicine? We now know enough about the limitations of "evidence" to be much more cautious about what passes for it. Perhaps the family medicine journals, individually or in concert, could start sections of their journals for the specific purpose of critically reviewing the results of published trials.
. . . .
Finally, we family physicians have a professional responsibility to be less naive about the inherent divergence of our patients’ and the drug companies’ best interests. Our patients must come first.
4) Drug Profits Infect Medical Studies -- Los Angeles Times, by John Abramson, MD, January 7, 2006
Then the lead author of a seminal article published in the journal Science reporting the creation of viable stem cells from cloned human embryos admitted he falsified results and resigned his academic post in disgrace.