Does collaboration with the drug industry affect clinical decisions?
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Does collaboration with the drug industry affect clinical decisions?
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This is a bit of a hot topic at the moment. The Ethical Standards in Health and Life Sciences Group have written guidelines which state doctors shouldn't be not to be “tempted to accept th
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Does collaboration with the drug industry affect clinical decisions?
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Does collaboration with the drug industry affect clinical decisions?
posted at 1/5/2012 2:30 PM BST
on bmj.com
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*Moderator*
Posts: 1436
First: 7/4/2011 Last: 17/5/2013 |
This is a bit of a hot topic at the moment. The Ethical Standards in Health and Life Sciences Group have written guidelines which state doctors shouldn't be not to be “tempted to accept the negative myths about cooperating with industry.” BMJ news reports that the guidance is supported by " the BMA, the Academy of Medical Royal Colleges, and the royal colleges of GPs, physicians, and psychiatrists. The Department of Health for England, the NHS Confederation, and the governments of Scotland and Wales also back the guide, which is aimed at achieving better cooperation with the industry for the benefit of patients at a time of budgetary constraint." Accoding to a letter/Rapid reponse in the BMJ - "it takes some sleuthing to discover that the guideline is written bt a multinational stakeholder group, seemingly coordinated by the Association of the British Pharmaceutical Industry (ABPI). Neither the group's membership or funding is declared in the guidance or the ABPI website. So much for transparency." It has surprised some people that major medical organisations have backed this report, without enquring into the authors links to industry or the evidence used in the report to back up claims. There are concerns about doctors' collaboration with the drug industry - are there conflict of interest if a drug company pays for a dinner or accomodation etc. Does this collaboration impact on clinical decisions made? |
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 5/5/2012 1:21 AM BST
on bmj.com
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Posts: 3037
First: 27/3/2012 Last: 18/5/2013 |
Definitely, there are bound to be conflicts of interest if a drug company pays for a dinner or accomodation etc for a doctor & this collaboration does have an impact on clinical decisions made. A nice & practically very hot topic for discussion! |
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 5/5/2012 1:18 PM BST
on bmj.com
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Posts: 3
First: 5/5/2012 Last: 16/8/2012 |
They are hard headed commercial businesses with a mission to maximise profit, anything they do is directed to this end. It has been demonstrated for years that the extent of one's involvement with drug companies influences both one's prescribing behaviour and the likelihood that one will press for the inclusion of a particular company's drugs in the hospital pharmacopoeia. This has also been seen in the behaviour of doctors on expert panels, one only has to look at DSM-4 and the forthcoming DSM-5 to see this. Put plainly, they wouldn't do it if it didn't work. Their shareholders would revolt. Drug manufacturers and infant formula manufacturuers trawl the marketing and psychology faculties of the top universities for their top graduates as recruits. They are then put to work influencing you and me. When one factors this in, together with the tens of thousands of pounds budgeted per doctor, it is clear that we are babes in the woods against it and that any belief that "we are too ethical to let such influences affect us" is a fantasy. The only solution is to have nothing to do with them or perhaps to have any contact absolutely open for all the world to see, this down to the last pen or post-it note. I prefer a Departmental policy of not letting them over the threshold ( no drug reps, infant formula reps or sponsorship of any kind allowed ). Department has survived with this policy for 15 years and the world has not ended. Andrew Watkins Australia |
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 5/5/2012 2:02 PM BST
on bmj.com
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Posts: 624
First: 13/4/2011 Last: 15/5/2013 |
In Response to Does collaboration with the drug industry affect clinical decisions?: This is a bit of a hot topic at the moment. The Ethical Standards in Health and Life Sciences Group have written guidelines which state doctors shouldn't be not to be “tempted to accept the negative myths about cooperating with industry.” BMJ news reports that the guidance is supported by " the BMA, the Academy of Medical Royal Colleges, and the royal colleges of GPs, physicians, and psychiatrists. The Department of Health for England, the NHS Confederation, and the governments of Scotland and Wales also back the guide, which is aimed at achieving better cooperation with the industry for the benefit of patients at a time of budgetary constraint." Accoding to a letter/Rapid reponse in the BMJ - "it takes some sleuthing to discover that the guideline is written bt a multinational stakeholder group, seemingly coordinated by the Association of the British Pharmaceutical Industry (ABPI). Neither the group's membership or funding is declared in the guidance or the ABPI website. So much for transparency." It has surprised some people that major medical organisations have backed this report, without enquring into the authors links to industry or the evidence used in the report to back up claims. There are concerns about doctors' collaboration with the drug industry - are there conflict of interest if a drug company pays for a dinner or accomodation etc. Does this collaboration impact on clinical decisions made? Posted by mbillingsley Hello mbillingsley: Could You provide the link to this News Report in BMJ. I am not finding it in BMJ. Thanks for the attention, Joey |
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 16/5/2012 10:16 AM BST
on bmj.com
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*Moderator*
Posts: 1436
First: 7/4/2011 Last: 17/5/2013 |
In one of the BMJ Rapid Responses to a Risk of cardiovascular serious adverse events associated with varenicline use for tobacco cessation, it is suggested that the findings in the recent systematic review and meta-analysis by Proschaska and Hilton - where they found no significant increase in serious cardiovascular events associated with varenicline use- that the trials they reviewed were funded by industry. The rapid responder - Mira Harrison-Woolrych- says that ". This conclusion is not consistent with the findings of a previous meta-analysis [and] which of the 22 trials included in the Prochaska review were company-funded studies? The largest study included [3] in this review was sponsored by Pfizer Inc (sponsor of Champix®) and pharmaceutical industry involvement in clinical trials may affect the outcomes of studies. It would be helpful if the authors of the recent meta-analysis could publish information about sponsorship of each study included in their review and discuss whether this may have had any effect on the results." Elsewhere in the BMJ, Ray Moynihan has written a brilliant article in response to these guidelines (in my original post) being published, called "The dos and don’ts of collaborating with industry" and offers some further advice which the guidelines might have missed in terms of persuading doctors to collaborate more with insdustry... by ignoring the mass of evidence contrary to the benefits outlined in this new guidance document... As Moynihan concludes: "This latest guidance on collaboration is extremely welcome, not as a guide to practice, but as an Orwellian insight into a desperate attempt to defend the indefensible.” |
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 16/5/2012 1:40 PM BST
on bmj.com
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Posts: 324
First: 23/12/2011 Last: 3/5/2013 |
I have read both Mr Moynhihans recent report in the BMJ and the original guidance published by the ABPI that it is based. |
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Of Course, Collaboration with the drug industry affect clinical decisions!
posted at 16/5/2012 1:49 PM BST
on bmj.com
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Posts: 624
First: 13/4/2011 Last: 15/5/2013 |
Hello Matthew: Thank you for bringing to us this hot and important topic. I would say that in the huge diabetes world and market, the main targets, as enemies (declared or not) of good diabetes treatment for the drug industry now, are the following: - Life Style Interventions. - Metformin. - Newer Generation Sulfonylureas, or just Sulfonylureas in general. - Generic Insulins. All Best, Joey
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 16/5/2012 2:35 PM BST
on bmj.com
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Posts: 220
First: 10/12/2010 Last: 1/6/2012 |
Hi Joey ! Long time no see! This is what is happening in developed world. What is the picture in developing counteries? One word only: HORRIBLE Daily plane loads are leaving Pakistan airports full with doctors to Bankok, Singapore, Tashkent, Istambule and other destinations. Mathematics is simple; You prescribe medicines of this much worth, you will be entitled to this and this package. I have seen a worst example of this behaviour. A middle aged female patient of 40 yrs old, labelled as pre diabetic, was prescribed Sitagliptin and Rosuvastatin along with lot of fear of disease, if she does not continue for life; Remember she has to purchase drugs herself. There is no NHS here. This was done by a Professor of Endocrinology; a well respected and supposedly honest upright man; Was it justified? Was this under the influence of some recent trip? What was this. This is not one example. This is not atypical behaviour; this is fast becoming a typical behaviour. |
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Re: Does collaboration with the drug industry affect clinical decisions?
posted at 30/5/2012 10:21 PM BST
on bmj.com
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Posts: 624
First: 13/4/2011 Last: 15/5/2013 |
Hello Ranasaleem: What you are mentioning here is clearly writen by the author of the following recent BMJ article when speaking about the role of pharmaceutical companies in promoting diabetes care and drugs in developing countries: "The drug industry is a barrier to diabetes care in poor countries"All Best, Joey
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