Thursday, April 17, 2008

Commercilaization of Research: Plague of Sponsorship

"People, not profits, must be at the centre of patent law for medicines"
Desmond Tutu

This exquisite short article in JAMA (Journal of the American Medical association) reveals the anguish of a non-conformist doctor amongst the sponsored commercial circus of pharmaceutical companies in seminars. Pharmaceutical companies are often the most unscrupulous practitioners of questionable research, and get away with the clout of money power. Plagiarism and unethical publishing are quite commonly resorted to by these corporates as also planted findings, that have no real clinical merit or have never undergone clinical trials. The WTO regime has often been used by these bodies to beat down competition from players in developing countries, who could offer medicines at a fraction of the price quoted by the multinational pharma giants like Novartis of Switzerland and Merck etc.

Rainbow to Dark Clouds

Catherine D. DeAngelis, MD, MPH

JAMA. 2005;294:1107.

This year it was my honor to have been the commencement speaker at 3 medical schools: Drexel University, University of California, Los Angeles (UCLA), and the University of Texas at Houston. On each occasion, I felt the same euphoria that I had at my own graduation and at the other commencements in which I spoke or, as Vice Dean of Academic Affairs and Faculty at Johns Hopkins School of Medicine, helped with the proceedings. It is exhilarating to experience, up close and personally, the enthusiasm and excitement of so many new physicians who clearly sense their potential to help those who will seek their care, and who want to fulfill their dreams of doing so.

One of the most touching of all moments in this year’s ceremonies occurred at UCLA. The "benediction" involved 24 graduating physicians joining the chaplain on stage to speak in the native language of their ethnic groups, no matter whether they were 1st- or 10th-generation Americans. The 24 languages spoken ranged from Afrikaans through Gujarati, Hindi, Mandarin Chinese, Tigrinya, and Urdu to Vietnamese. The phrase each graduate spoke was, "May we leave here to cure when possible, and to care always." What could be better wishes for healers to declare publicly? I wept along with most in the audience.

Early the next morning, I flew to San Diego to speak at an international meeting of subspecialists; which subspecialty is unfortunately irrelevant because it could have been almost any one. The geographic distance is 111 miles; the psychological distance was an eternity. As I walked off the plane, I was greeted with several ads prominently placed in the airport inviting physicians to visit one exhibit booth or another. It’s a free country, so why not? It was too early to check into the hotel, so I went to the convention center to register. On the way I passed hundreds of people (many certainly were physicians) walking from the center with identification cards in plastic cases hung around their necks on a ribbon emblazoned with the name of a pharmaceutical company. They were also carrying cloth bags adorned with large logos of several pharmaceutical companies—oh, and also the name of the subspecialty society. I politely declined both when they were offered to me, much to the chagrin of the sweet woman who worked the registration desk.

When I arrived at the room where I was to speak, a giant placard outside listed the names of the speakers and times of presentations—and the announcement by the names of several speakers that their presentations were sponsored by a particular pharmaceutical company. Of course, there were statements all over the podiums and in the rooms stating that all "sponsored" discussions involved funds from "unencumbered educational grants" that had nothing to do with the choice of speakers or topics. The spirit displayed at the conference was in such contrast to that displayed at the previous day’s commencement. What happened to the altruistic, "above all, help the patient" spirit?

After completing my presentation on conflicts of interest (the conference committee apparently had a sense of irony), I returned to the hotel to register. I was handed my room key: a plastic card with the name and logo of a pharmaceutical company on one side and an invitation to "visit us at booth #1501." Once again, I wept—this time, alone.

Merck's unethical publishing activities

Merck has misrepresented research data and manipulated clinical research articles and clinical reviews, says the latest issue of JAMA. Merck & Co Inc manipulated dozens of publications to promote one of its products. Documents that provided evidence necessary to demonstrate the manipulation became public (and publishable) because of litigation involving one of that company's products, rofecoxib (used in the treatment of Alzheimer disease or cognitive impairment .


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