![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Dr. Bob on April 26, 2004, at 8:49:02
In reply to Drug makers deceive doctors, posted by Rick on April 25, 2004, at 14:54:58
> That's the title of this interesting article. Of course, to the extent it's true, it can affect what our pdocs will (and won't) prescribe. It's not mentioned here, but I believe Pfizer has been accused of doing this a lot. They are the world's biggest drug company and make blockbusters like Zoloft, Lipitor and Neurontin. I do know they are in trouble with the FDA for touting Neurontin for unapproved uses, and I believe ghostwriting was somehow involved in the accusations.
>
> Rick
>
> http://www.straightgoods.ca/ViewFeature3.cfm?REF=576
>
> DRUG MAKERS DECEIVE DOCTORS
>
> Pay "authors" of major studies for use of their name, credibility; ask minimal participation in research or writing.
>
> Dateline: Friday, April 16, 2004
>
> By Gordon Guyatt
>
> Peter (not his real name) is a physician-scientist who, a couple of years ago, was finishing his research training in Canada. Shortly before returning to his native Australia, Peter received an interesting offer.
>
> A pharmaceutical company was ready to pay Peter several thousand dollars to write an opinion piece for a prominent medical journal. Peter is smart, and a good writer. Producing the article would be a cinch. Attractive proposition, no?
>
> Well, a couple of catches. First, Peter would have to follow the company's direction about what to say. Second, when the article was published, Peter's name would not appear.
>
> Rather, a respected senior researcher who has conducted many studies funded by the pharmaceutical industry would get the credit.
>
> Peter refused the offer. The company probably succeeded in finding a different, willing ghost-writer.
>
> Like all unethical practices, it is difficult to establish the size of the medical ghost-writing problem. Senior authors will never threaten their prestige by admitting someone else wrote their article. Professional ghostwriters won't embarrass their clients. People like Peter won't embarrass their colleagues.
>
> Ghost writing is a big enough business, though, to sustain companies focused on medical writing. Medical editors recognize ghostwriting as a widespread practice and have tried to tighten up their rules. Still, there is no protection against misleading or dishonest representations, and authorities suggest that up to 50% of articles reporting results of pharmaceutical trials are ghostwritten.
>
> Lead authors of major drug studies may not only have done little of the writing, but their participation in the research itself may have been minimal. Company personnel may have developed the research plan, supervised the collection of the data, conducted the analyses, and written the first draft of the article.
>
> The companies then go to prominent researchers, and ask: "Would you like to be an author, or even the leading author, on the article?"
>
> The higher the profile of the author, the better for the company. The author's prestige helps to establish the credibility of the study, and contributes to the attention that the article receives.
>
> While these extreme situations are not the most common way drug studies are reported, they merge into a grey area that is very common. Academic researchers may participate in planning the study and carrying it out, but they may never see the actual data. The company conducts the analysis, and presents the academic authors with tables that summarize the results.
>
> A McMaster University researcher, P.J. Devereaux, has just completed a study comparing how medical scientists report their research, and what actually happens in their studies.
>
> To carry out his research, Devereaux interviewed authors over the phone, asking them detailed questions about the conduct of their studies.
>
> One lead author of a study published in a top journal had little idea what happened. He informed Devereaux that the company had completed the study, analyzed the data and wrote the first draft of the article. He advised Devereaux to contact the company for further information about the trial.
>
> On other occasions, Devereaux found that authors' knowledge was sketchy because their role in the planning, conduct and particularly the analysis of their studies was limited.
>
> Such situations mean that academic authors may never see important information, or that the company may present results in a misleading way.
>
> That helps to explain the findings of a recent study showing that the odds of industry-funded trials enthusiastically recommending treatment are more than five times as great as non-industry funded studies.
>
> Biased presentations affect not only how individual doctors understand research results, but how experts who create guidelines understand the results. Worse yet, the industry exerts direct influence on those experts.
>
> Investigators at the University of Toronto conducted a survey that included 44 guidelines designed to help doctors make decisions about diagnosis and treatment for their patients.
>
> The Toronto researchers found that 58% of guideline developers had received research funding from the industry, and 38% had served as employees or consultants. Fifty-nine per cent had relationships with companies whose drugs were considered in the guideline they authored.
>
> Whether they are recruiting ghostwriters, giving credit to academic authors while controlling the conduct and analysis of research studies, or providing generous funding to researchers, the industry's goal is the same. Having researchers and experts carry their sales pitch to the practising doctor enhances the credibility of the company's message.
>
> The result is often poorer and less efficient patient care. Industry bias leads to overuse of medication, and particularly overuse of new drugs.
>
> Drugs that are recently developed and released are far more expensive. About 25% of the time, these new drugs turn out to have serious side effects that are not suspected at the time they were released. On occasion, these side effects are fatal.
>
> Doctors expect objectivity in the research reports and expert recommendations that guide their practice. Too often, the drug industry ensures that bias, rather than objectivity, is what doctors receive.
>
> Gordon Guyatt MD, FRCPC, lives in Dundas, Ontario. He is an academic physician at McMaster University's Department of Clinical Epidemiology and Biostatistics and Department of Medicine.
>
Posted by Fallen4MyT on April 26, 2004, at 17:34:43
In reply to Drug makers deceive doctors « Rick, posted by Dr. Bob on April 26, 2004, at 8:49:02
Hey Rick I found this very intresting because I saw a 60 minutes on Neurontin and how it was pushed to docs by a dude that lied per his superiors on it., I am a firm believer that many drugs are overused and misued cause of this practice and the trips and all
Posted by Dr. Bob on April 27, 2004, at 21:46:42
In reply to Drug makers deceive doctors « Rick, posted by Dr. Bob on April 26, 2004, at 8:49:02
Posted by Rick on April 26, 2004, at 16:28:46
In reply to Redirect: Drug makers, posted by Dr. Bob on April 26, 2004, at 8:52:24
> It's about drug makers more than drugs.
I respectfully but heartily disagree. It's very much about making informed drug decisions.
The reason I posted this here is not as a putdown of drug companies practices, but as a reminder of another very important consideration to take into account when weighing drug treatment options with one's doctor.
While the ghostwriting aspect is interesting, it's the potential research "spin" aspect that we need to be reminded of. It's a reminder to the patient to gather as much anecdotal evidence as possible (read Psycho-Babble!), and always consider that some drug research -- and all drug advertising -- has a primary goal of profit. (I'm not making a judgement here, just stating *facts* that all should be aware of in seeking optimal drug treatments.)
In fact, my post was largely meant to reinforce what you say near the top of the *medication-related issue* page, namely "Don't necessarily believe everything you hear." As the article points out, "The result is often poorer and less efficient patient care. Industry bias leads to overuse of medication, and particularly overuse of new drugs." This is *very* useful knowledge in making an informed *medication selection*, i.e., don't assume the "latest and greatest" will necessarily work better for you than old off-patent meds, despite the all the hype.
Through various routes, drug-company bias -- whether justified or not -- can filter through to posts, too, especially where people aren't relating their own first-hand experiences.
Information in the article has very practical and direct application to the process of honing in on one's optimal medication therapy.
Rick
Posted by Dr. Bob on April 27, 2004, at 21:51:10
In reply to Re: Redirect: Drug makers « Rick, posted by Dr. Bob on April 27, 2004, at 21:46:42
> > It's about drug makers more than drugs.
>
> I respectfully but heartily disagree. It's very much about making informed drug decisions.
>
> it's the potential research "spin" aspect that we need to be reminded of.I agree, that's important to keep in mind, but IMO, it's still more about drug makers than drugs... Let's agree to disagree?
Bob
Posted by Rick on April 28, 2004, at 0:50:36
In reply to Re: making informed drug decisions, posted by Dr. Bob on April 27, 2004, at 21:51:10
> I agree, that's important to keep in mind, but IMO, it's still more about drug makers than drugs... Let's agree to disagree?Sure that's fine. But even assuming the topic is drug makers, the thread seems even more off-topic here than on the medication page. I glance up and down PB "Social" and find that this subject seems sorely out of place with the cyber-socializing and laudable individual-support threads that comprise this section. I honestly did peek over here before submitting the original post (I had never visited PB Social before and wondered if this is where it should go), but quickly concluded it didn't fit in at all with what I saw. Maybe you should have a PB "Everything Else".
BTW, I'm not seeking any decision-reversal or response here, just giving feedback. (Oops, as I wrote that last sentence it occurred to me...should I have posted this in PB Administration instead?)
Thanks,
Rick
Posted by Rick on April 28, 2004, at 1:21:15
In reply to Re: Drug makers deceive doctors » Dr. Bob, posted by Fallen4MyT on April 26, 2004, at 17:34:43
> Hey Rick I found this very intresting because I saw a 60 minutes on Neurontin and how it was pushed to docs by a dude that lied per his superiors on it., I am a firm believer that many drugs are overused and misued cause of this practice and the trips and all
Yeah, I remember reading all about that situation, Fallen4MyT. Pretty wild.
I do believe that companies should try to promote their drugs (hopefully pdocs are smart enough to sift through the pitches, though I'm a little more concerned about GP's). And I definitely believe in off-label uses where well supported. For instance, I take arguably the most effective social phobia med -- Klonopin -- but it never received an FDA indication for SP. And (speak of the devil), off-label Neurontin works wonders for my friend's periodic limb movements of sleep.
All that said, there is some deception and "sneakiness" going on out there that is troubling, especially since we're talking about products lives depend upon. These practices no doubt result in sometimes suboptimal treatments, overuse of some drugs (as you say), and needless expense.
Rick
Posted by Dr. Bob on April 28, 2004, at 22:05:56
In reply to Re: making informed drug decisions » Dr. Bob, posted by Rick on April 28, 2004, at 0:50:36
> even assuming the topic is drug makers, the thread seems even more off-topic here than on the medication page.
Well, you have a point there... A new board for drug makers? The health care industry?
> Maybe you should have a PB "Everything Else".
That's actually one of the roles of this board. :-)
Bob
This is the end of the thread.
Psycho-Babble Social | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.