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By Nathan Newman
I n June, the New England Journal of Medicine, one of the most respected
medical journals, made a startling announcement. The editors declared that
they were dropping their policy stipulating that authors of review articles of
medical studies could not have financial ties to drug companies whose
medicines were being analyzed.
The reason? The journal could no longer find enough independent experts.
Drug company gifts and "consulting fees" are so pervasive that in any given
field, you cannot find an expert who has not been paid off in some way by the
industry. So the journal settled for a new standard: Their reviewers can have
received no more than $10,000 from companies whose work they judge. Isn't
This announcement by the New England Journal of Medicine is just the tip of
the iceberg of a scientific establishment that has been pervasively corrupted
by conflicts of interest and bias, throwing doubt on almost all scientific
claims made in the biomedical field.
The standard announced in June was only for the reviewers. The actual authors
of scientific studies in medical journals are often bought and paid for by
private drug companies with a stake in the scientific results. While the NEJM
and some other journals disclose these conflicts, others do not. Unknown to
many readers is the fact that the data being discussed was often collected and
analyzed by the maker of the drug involved in the test. An independent 1996
study found that 98 percent of scientific papers based on research sponsored
by corporations promoted the effectiveness of a company's drug. By comparison,
79 percent of independent studies found that a new drug was effective. This
corruption reaches from the doctors prescribing a drug to government review
boards to university research centers.
There have long been worries about the advertising and promotional gifts given
to doctors to influence which drugs they prescribe. But it turns out that even
deeper financial ties extend to the medical experts setting nationwide
professional guidelines for treating conditions ranging from heart disease to
diabetes. Surveys have found that nine out of ten experts writing such
guidelines have financial ties to the pharmaceutical industry, yet those ties
are almost never disclosed in the treatment guidelines, which are often
published in medical journals and endorsed by medical societies.
The Food and Drug Administration, for reasons similar to those of the
medical journals, routinely allows researchers with ties to the industry to
sit on drug approval advisory committees. In many cases, half the panelists
on such committees have a financial stake in the outcome, through links to
the drug manufacturer or to a competitor.
Increasingly, the industry has converted academic research centers into
subsidiaries of the companies. The billions of dollars of academic government
funding essentially pays to flush out negative results, while private industry
gets to profit from any successful result. Industry now provides 7 percent of
university research funding, but they are manipulating the system to gain a
far more substantial benefit. At the University of California at Berkeley,
Novartis agreed to pay $25 million to the campus in exchange for the first
right to patent a range of basic plant research produced by the university.
Where once university research was oriented to producing independent knowledge
that any other researcher could access and improve upon, university research
is increasingly being locked up in patents. What's more, scientists at
universities are often allowed to have stock options in companies benefiting
from the research they are conducting. As Dr. Marcia Angell, a former editor
of The New England Journal of Medicine, noted in the Baltimore Sun, "What
would be considered a grotesque conflict of interest if a politician or judge
did it is somehow not in a physician."
And the results are expensive and sometimes tragic for the public.
Experimental clinical drug trials are hazardous to participants and, more
broadly, critical to those with life threatening conditions who need to know
which treatments are fruitless to pursue. Yet researchers on industry payrolls
end up pressured to suppress negative results.
At the most basic level, researchers who defy their corporate sponsors know
they may lose their funding. When one Toronto scientist revealed in 1998 a
serious side effect of deferiprone, a drug for a blood disorder, her contract
was terminated. More dramatically, when a number of researchers concluded
thatRemune, an anti-AIDS therapy, was of little benefit to patients, the
companyfunding their research, the Immune Response Corporation, sued
the scientistsin 2001 for $10 million for damaging its business.
And these are the examples of scientists who spoke out. Many others just go
along with the demands of their corporate sponsors and suppress negative
evidence. In the early 1990s, a pharmacologist at the University of California
at San Francisco, Betty Dong, found that a generic thyroid hormone worked as
well as Synthroid, the brand-name drug made by the funder of the research.
According to the Washington Post, the company, Knoll Pharmaceuticals,
successfully blocked publication of the findings for seven years. Only in 1997
was this fraud discovered, and in 1999 Knoll had to pay 37 states $42 million
to settle a suit for consumer fraud in promoting the superiority of its drug.
This pattern of suppression means that medical knowledge is being stunted and
delayed, as other researchers aren't informed of dead ends that might have
helped steer their own research. And by locking up knowledge produced at
academic centers in patents, what should be free knowledge for the public
(free in both the intellectual and economic sense) instead feeds the profit
margins of the pharmaceutical industry.
Universities once opposed patents for any academic research. Yale University's
1948 policy on patents stated, "It is, in general, undesirable and contrary to
the best interests of medicine and the public to patent any discovery or
invention applicable in the fields of public health or medicine." That policy
was later abandoned and Yale now holds a key anti-AIDS drug patent jointly
with Bristol Myers. Facing massive global protest, Yale last year agreed to
relax its patent rules, but the fact that universities routinely now balance
who will live and die against their own profit motive is a degradation of
their public purpose.
This corruption of academic science is pervasive and the costs are extremely
clear, but what is remarkable is how easy it would be to end. Federal and
state governments still supply the overwhelming percentage of university
research funding. If all such funding was conditioned on ending non-disclosure
agreements and on barring the licensing of government-funded results to
private industry, the public would benefit both scientifically and financially.
We've paid for the knowledge once. We shouldn't have to do soagain in increased
costs of medicine and increased deaths due to suppressedknowledge.
Thank You Nathan Newman
God Bless Everyone & God Bless The United States of America.
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